Anesthetic Consideration for Peroral Endoscopic Myotomy
- Author:
Yun Sic BANG
1
;
Chunghyun PARK
Author Information
- Publication Type:Review
- Keywords: Complication; General endotracheal anesthesia; Peroral endoscopic myotomy
- MeSH: Anesthesia; Anesthesia, General; Carbon Dioxide; Endoscopy; Esophageal Achalasia; Hemodynamics; Hemorrhage; Incidence; Insufflation; Mediastinal Emphysema; Patient Safety; Pneumoperitoneum; Pneumothorax; Subcutaneous Emphysema
- From:Clinical Endoscopy 2019;52(6):549-555
- CountryRepublic of Korea
- Language:English
- Abstract: A recent achalasia guideline suggests that peroral endoscopic myotomy (POEM) is a safe option for achalasia that is as effective as Heller myotomy. It is recommended that POEM should be performed under general anesthesia. The incidence of adverse events such as bleeding, perforation, and carbon dioxide insufflation-related complications was lower in POEM under endotracheal general anesthesia than in POEM under sedation. Subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, and accompanying hemodynamic instability can be caused by carbon dioxide insufflation. Treatment of possible physiological changes and adverse events during the POEM procedure from the point of view of anesthesiologists may give endoscopists a new perspective on improving patient safety. The territory of therapeutic endoscopy can be expanded through cooperation with other departments, including anesthesia services. Efforts to understand different perspectives will certainly help not only secure patient safety but also expand the area of treatment.
