EGD for GI Bleed: Tube or not?

[wickedskillz]

Personal experience, I dont like the laryngospasm that tends to happen with low dose Ketamine. I used to love it but then found myself fighting spasms for what should've been otherwise simple sedations.

Also horrible when you don't get the bite block in before the ketamine and they clench their Jaw super hard. Had to convert to GA twice for that, which is my bad since I should have learned my lesson after the first time........

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[Impromptu]

This thread was floating through my mind last week when I asked to provide anesthesia for an upper GI bleed. The bleeding had last occurred the evening before. The GI doctor predicted that it was a Mallory-Weiss tear from this's patient's coughing due to a cold. It was. He was surprised at how much blood was still in the stomach and complemented me for having the foresight to choose general anesthesia.

While I likely would have chosen general because the last bloody vomit was less than 24 hours ago, this thread helped me make this choice with much more conviction. Thanks.