Unsedated percutaneous endoscopic gastrostomy insertion: a safe, effective, and well-tolerated method

Area of Science:

• Gastroenterology
• Medical Procedures
• Patient Safety

Background:

• Percutaneous endoscopic gastrostomy (PEG) tube insertion is often uncomfortable and requires sedation.
• Sedation poses risks, potentially delaying or preventing PEG tube placement in some patients.
• This study examines an alternative approach for PEG insertion.

Purpose of the Study:

• To evaluate the feasibility and safety of unsedated peroral PEG tube insertion.
• To assess patient acceptance of the unsedated procedure.
• To demonstrate the applicability of this technique in standard gastroenterology units.

Main Methods:

• A retrospective case series of 10 patients undergoing unsedated PEG insertion.
• Pharyngeal anesthesia with 1% lidocaine and local anesthesia were administered.
• The push-pull technique was employed for PEG tube insertion.

Main Results:

• All procedures were performed without complications.
• Patients found the unsedated PEG insertion acceptable and less unpleasant than anticipated.
• Respondents indicated willingness to undergo the procedure again using this method.

Conclusions:

• Unsedated peroral PEG insertion is a safe and viable option for patients at increased risk from intravenous sedation.
• Gastroenterology units can perform this procedure without specialized equipment.
• This technique offers a practical solution for patients who cannot undergo sedation.