MAC or GETA for gastric balloon removal?

[narcotics999]

Had my first case a few days ago. First time for GI MD too.

Did not suspect too much, I started the case as regular EGD with Propofol. Scope in, saw big balloon. 100ml out, food junk appeared. Requested GI to take out the scope and intubated the pt.

GI MD and staff whined. Just small food particles as the scope is 10x magnified. GI room not equipped with ventilator. Blah blah.

The food junk is not small and of significant quantity. The case took more than 1hour (liquid removal not efficient, balloon slippery).

I am thinking GETA for this type of case in the future. Also recommend soft diet the night before procedure.

What is your approach? I don’t have much experience.

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[Arch Guillotti]

Never done one.

GETA with anesthesia machine in room.

 

[deleted162650]

We do these with some regularity at one our outpatient GI gigs. Our official group policy is that MAC is fine for balloon placement, but GETA for all balloon removals.

 

[dhb]

Unprotected GA (MAC) in and out

 

[Arch Guillotti]

Unprotected GA (MAC) in and out

For an hourlong endo case. No thanks.

 

[narcotics999]

We do these with some regularity at one our outpatient GI gigs. Our official group policy is that MAC is fine for balloon placement, but GETA for all balloon removals.

What about last preop-meal? The stomach is littered with food with standard NPO guideline.

 

[GravelRider]

Unprotected GA (MAC) in and out

I believe it’s always advisable to use protection if you’re going to do the old in and out.

 

[deleted162650]

What about last preop-meal? The stomach is littered with food with standard NPO guideline.

Not really sure what you're asking. We go by standard NPO guidelines. Once the balloon has been in there, the stomach never empties that well. Hence the GETA for all removals.

 

[dhb]

For an hourlong endo case. No thanks.

It should be less than 10min.

 

[Psai]

It should be less than 10min.

How often is it though

 

[narcotics999]

Not really sure what you're asking. We go by standard NPO guidelines. Once the balloon has been in there, the stomach never empties that well. Hence the GETA for all removals.

What I mean is since the stomach does not empty well, should I request soft diet or less for the last preop meal to decrease particulate residue?

 

[Noyac]

I have read none of the comments, nor the OP’s post. I am responding solely on the title alone.
If you ask MAC vs GA, then most likely you will be glad you went with GA.

 

[Noyac]

We do these with some regularity at one our outpatient GI gigs. Our official group policy is that MAC is fine for balloon placement, but GETA for all balloon removals.

I don’t know how to read this.
I’m looking for the hilarious smartass comment. I know it’s in there somewhere. I just can’t find it.

 

[deleted162650]

I don’t know how to read this.
I’m looking for the hilarious smartass comment. I know it’s in there somewhere. I just can’t find it.

I try to maintain a 9:1 ratio of sarcastic off-color comments to clinically relevant useful information.

 

[Noyac]

I was thinking it was more like 99:1