75 yo , active aspiration pneumonia, large hiatal hernia (high risk for aspiration) for a PEG.

[PieOHmy]

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what is the best way to anesthetize this patient?

 

[patriot6]

Prop Sux Tube

what is the best way to anesthetize this patient?

 

[ZzzPlz]

Burn down the stables and collect the insurance money. Oh wait bad idea.

Sorry couldn’t help myself pieOHmy

 

[Arch Guillotti]

propofol

 

[UscGhost]

Propofol. Pt is npo. GI doc can suction on the way down

 

[coffeebythelake]

Intubate. I think anything else is difficult to defend if the pt aspirates (again).

 

[PieOHmy]

Burn down the stables and collect the insurance money. Oh wait bad idea.

Sorry couldn’t help myself pieOHmy

Most wont get that reference

 

[deleted59964]

if has a NG, best anaesthetic is local - perc inserted by radiology

 

[woopedazz]

I had one of these and we did what JobsFan said.

They suction them completely dry through the NGT prior to starting and you can always put a new/extra/withdraw the NGT into the hernia to make sure that's dry as well.
Radiologically they confirm empty hernia + stomach prior to giving any sedation.
Then just trickle in a bit of propofol for the LA injection and away you go.

 

[facted]

Ketamine.