ALS and Anesthetic Management

Two weeks ago, I had a patient who came in for exploratory laparotomy s/p peg tubal insertion. She has unrelieved pain after the peg tube placement. Patient is in her mid 30’s. Needed the ped tube due to losing weight. She has been bedridden for a year and exhibited muscle atrophy in her extremities. She can converse but has a little slurred speech. She claimed that she had a cinnamon roll at 10am. And the surgery was scheduled going in at 7pm.

How would you manage this patient? Any thoughts?


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