Tan RX, Liu HB, Zuo YD, Qiu YH. Monitored anesthesia care combined with thoracic paravertebral block for percutaneous endoscopic gastrostomy: A case report. World J Clin Cases 2026; 14(25): 124535 [DOI: 10.12998/wjcc.124535]
Corresponding Author of This Article
Yan-Hua Qiu, MD, PhD, Department of Anesthesiology, Sichuan University, No. 17 Section 3, Renmin South Road, Yulin Subdistrict, Wuhou District, Chengdu 610041, Sichuan Province, China. 1781585803@qq.com
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Anesthesiology
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case-report
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Tan RX, Liu HB, Zuo YD, Qiu YH. Monitored anesthesia care combined with thoracic paravertebral block for percutaneous endoscopic gastrostomy: A case report. World J Clin Cases 2026; 14(25): 124535 [DOI: 10.12998/wjcc.124535]
World J Clin Cases. Sep 6, 2026; 14(25): 124535 Published online Sep 6, 2026. doi: 10.12998/wjcc.124535
Monitored anesthesia care combined with thoracic paravertebral block for percutaneous endoscopic gastrostomy: A case report
Rui-Xi Tan, Hai-Bei Liu, Yi-Ding Zuo, Yan-Hua Qiu
Rui-Xi Tan, Yi-Ding Zuo, Yan-Hua Qiu, Department of Anesthesiology, Sichuan University, Xiamen 361000, Fujian Province, China
Hai-Bei Liu, Yan-Hua Qiu, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Co-first authors: Rui-Xi Tan and Hai-Bei Liu.
Author contributions: Tan RX and Liu HB contributed to manuscript writing and editing; Tan RX, Liu HB, and Zuo YD contributed to data collection; Qiu YH contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
AI contribution statement: AI tools, specifically Deepseek, were used solely for language polishing and formatting assistance. No AI tool was used to generate research data, interpret results, or formulate conclusions. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yan-Hua Qiu, MD, PhD, Department of Anesthesiology, Sichuan University, No. 17 Section 3, Renmin South Road, Yulin Subdistrict, Wuhou District, Chengdu 610041, Sichuan Province, China. 1781585803@qq.com
Received: June 23, 2026 Revised: July 24, 2026 Accepted: August 20, 2026 Published online: September 6, 2026 Processing time: 77 Days and 21.7 Hours
Abstract
BACKGROUND
Percutaneous endoscopic gastrostomy (PEG) in patients with concurrent esophageal and tracheal stents presents significant anesthetic challenges due to the risk of stent displacement during airway manipulation. The combination of monitored anesthesia care (MAC) and thoracic paravertebral block (TPVB) has been used in various surgical settings, but its application in this specific high-risk population remains rarely reported.
CASE SUMMARY
This case report describes the successful use of MAC combined with TPVB in a high-risk patient with both esophageal and tracheal stents undergoing PEG. Bilateral TPVB at T6 and T8 Levels using 0.33% ropivacaine (10 ml per injection point) was performed, followed by propofol and remifentanil titrated to maintain optimal sedation under Bispectral index monitoring. Spontaneous ventilation was maintained via a nasopharyngeal airway with capnography. The procedure was completed with stable hemodynamics and minimal pain, avoiding endotracheal intubation entirely.
CONCLUSION
This case demonstrates MAC combined with TPVB may be a safe anesthetic option for PEG in patients with dual stents.
Core Tip: This case is the first to describe the use of monitored anesthesia care combined with thoracic paravertebral block for percutaneous endoscopic gastrostomy in a patient with concurrent esophageal and tracheal stents. The technique avoided endotracheal intubation, minimized stent displacement risk, and provided adequate anesthesia with stable hemodynamics and fast recovery.
