Moral of this post is: YOU DON'T HAVE TO INTUBATE D&Cs BECAUSE OF WHAT YOU'VE BEEN TAUGHT ABOUT "ASPIRATION RISK". OK. I know what the academic dudes say. D&C. Twelve week-or-greater uterus, you need a tube. Physiologic/hormonal changes effecting gastric emptying, blah blah blah. Most run-of-da'-mil private practice hospitals have GYN dudes that are skilled and you're talkin' about a 228 second procedure. INTUBATING THIS LADY IS OVERKILL AND YOUR ANESTHETIC WILL NOW BECOME A HURDLE GREATER THAN THE SURGERY. Because now you (and the lady) has to worry about sore throat from intubation, prolonged wake-up because she was paralyzed, N/v from reversal, etc. All because we were taught a twelve-week uterus means increased risk of aspiration. Which is WAY overplayed. Even though, in the United Kingdom, GA continues to be a well accepted anesthetic for C sections, with morbidity/mortality numbers no-worse than ours. So I'm calling BULLS HIT on the twelve week-ya-gotta-intubate-her rule. I think allopathic-anesthesia education on the risks of early-parturient aspiration are WAY overplayed. And my experience, and the experience of every clinician I know backs up that notion. Its very rare that I tube a D&C. midazolam 2 mg/ketorolac 30 mg on the way to the OR. Bring her in, hooker up. 150 mg propofol. N20 70%, O2 30 %. She'll start to breathe eventually. If the GYN dude is deft, no agent required. If he's struggling a little, crank the sevo/des commensurate to his struggle. D&C over? DC the yellow/blue gas on your-still-spontaneously-ventilating lady. You wanna tube every 12-week-and-greater-uterus-D&C? I respect your decision. I'm telling you that in eleven years of private practice I've tubed less than ten D&Cs. I'm either really lucky, or the teaching is too strong concerning aspiration risk. MOST D&Cs CAN BE DONE BY MASK/LMA GA. Unless you're working with an cdazy-slow private-practice GYN or academic institution-where-you're-growing-a-beard-waiting for the case to end.