Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement Periprocedural Care

Updated: Apr 11, 2017
  • Author: Gaurav Arora, MD, MS; Chief Editor: Danny A Sherwinter, MD  more...
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Periprocedural Care

Equipment

In addition to a standard upper endoscope, equipment used in percutaneous endoscopic gastrostomy (PEG) tube placement includes a PEG kit (commercially available) that contains the following:

  • PEG tube (see the image below)
  • Guide wire
  • Snare
  • Syringe, 5 mL
  • Needle, 22 gauge
  • Sterile fenestrated drape
  • Lidocaine
  • Needle/catheter assembly
  • Surgical blade, No. 11, attached to a scalpel
  • Gauze
  • Lubricant
  • Scissors
  • Swab sticks containing povidone-iodine solution
Percutaneous endoscopic gastrostomy (PEG) tube. Im Percutaneous endoscopic gastrostomy (PEG) tube. Image courtesy of Wikimedia Commons.
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Patient Preparation

Anesthesia

Typically, this procedure is performed with moderate sedation using intravenous midazolam and fentanyl (or meperidine), along with local anesthesia (ie, lidocaine) at the site of tube placement. However, some patients may require deeper sedation with an agent such as propofol, and this is usually administered and monitored by an anesthesiologist. For more information, see Procedural Sedation and Local Anesthetic Agents, Infiltrative Administration.

Positioning

The patient should be supine, with the head end of the bed elevated at a 30º angle to reduce the risk of aspiration.

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