Open AccessPeroral endoscopic myotomy—initial experience with anesthetic management of 24 procedures and systematic review
Author(s) -
Basavana Goudra,
Preet Mohinder Singh,
Gowri Gouda,
Ashish Sinha
Publication year - 2016
Publication title -
al-banǧ. maqālāt wa abḥāṯ fī al-taẖdīr wa-al-in’āš
Language(s) - English
Resource type - Journals
ISSN - 0259-1162
DOI - 10.4103/0259-1162.171462
Subject(s) - cricoid pressure , medicine , rapid sequence induction , achalasia , myotomy , aspiration pneumonia , surgery , esophagus , anesthesia , intubation , pneumoperitoneum , pneumomediastinum , tracheal intubation , perioperative , pneumonia , pneumothorax , laparoscopy
Peroral endoscopic myotomy (POEM) is a novel method of treating achalasia of the esophagus. Very little data are available to guide the anesthesia providers caring for these patients. The anesthetic challenges are primarily related to the risk of pulmonary aspiration. There is also a potential risk of pneumomediastinum, pneumoperitoneum, subcutaneous, or submucosal emphysema, as a result of carbon dioxide tracking into the soft tissues surrounding the esophagus and lower esophageal sphincter.