Assisted Sedation for Percutaneous Endoscopic Gastrostomy Procedure in Sick Patients in a Developing Country

In a developing country, the percutaneous endoscopic gastrostomy (PEG) procedure is being performed at an increasing rate. However, there is sparse information on the sedation for this procedure. The aim of our study was to evaluate the clinical efficacy of assisted sedation compared with general anesthesia for the PEG procedure in patients in a teaching hospital in Thailand. We undertook a retrospective review of records of patients who underwent PEG procedures from October 2006 to September 2008. All patients with ASA physical status III and IV were classified into two groups according to the type of anesthetic technique: Group S, intravenous sedation (IVS); and Group G, general anesthesia (GA). The primary outcome of the study was the successful completion of the procedure. The secondary outcomes were sedation/anesthesia-related complications during and immediately after the procedure. One hundred and eighty-four patients were enrolled with 116 (M, 52; mean age, 71.4±15.8 years) in Group S and 68 (M, 37; mean age, 67.8±18.5 years) in Group G. There were no significant differences between the two groups in age, gender, weight, and duration of procedure. All patients in both groups concluded with the successful completion of the procedure. Overall adverse events in group S occurred significantly less commonly than in group G (p=0.003). All complications were treated easily with no adverse sequelae. We concluded that in the setting of the developing country, assisted sedation for the PEG procedure in patients by trained anesthetic personnel with appropriate monitoring was safe and effective.