Expert: JM Starkman, MD - 3/29/2010

Question
Is it necessary to perform a morning HCG prior pain procedures like an epidural injection  or   Endoscopy procedures like a colonoscopy or EGD on a child-bearing patient?

Answer
This is usually a matter of protocol which varies from facility to facility.  As such, common sense or the latest published data are generally not the only factors given consideration.  For example,here in Florida, USA when this topic comes up the issue of "liability" is always raised, but a qualified attorney is never consulted for a formal legal opinion.  Many anesthesiology articles in peer-reviewed journals have addressed the matter.  So, what is 'necessary' has to do with protocol and how that protocol is written is subject to a wide variety of objective, subjective and irrelevant or erroneous influence.  If you're asking because you are writing a protocol, the answer will depend on your anesthesiologist and his way of doing things and he should be included in the discussion.