ArticleAnesthesia, essays and researches
Peroral endoscopic myotomy-initial experience with anesthetic management of 24 procedures and systematic review.
Article in Anesthesia, essays and researches. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 25 citations in OpenAlex.
- Third space endoscopy pulmonary complications and chylothorax post peroral endoscopic myotomy.World journal of methodology · 2025Review
- Evaluation of Anesthesia Management During Peroral Endoscopic Myotomy in Patients with Achalasia: A Retrospective Study.Journal of clinical medicine · 2025Article
- The Ventilatory Changes of Pediatric Peroral Endoscopic Myotomy Patients.Turkish journal of anaesthesiology and reanimation · 2024Article
- Pediatric anesthesia and achalasia: 10 years' experience in peroral endoscopy myotomy management.Journal of anesthesia, analgesia and critical care · 2022Article
- Effect of Drinking Warm Water on Esophageal Preparation Before Peroral Endoscopic Myotomy in Patients With Achalasia.Journal of neurogastroenterology and motility · 2022Article
- Anesthesia for Advanced Endoscopic Procedures.Clinical endoscopy · 2022Review
- Reversibility of Endoscopic Features after Treatment for Eosinophilic Esophagitis.Yonsei medical journal · 2021Article
- Anesthetic Consideration for Peroral Endoscopic Myotomy.Clinical endoscopy · 2019Review
- Problems in beginning a "POEM".Indian journal of anaesthesia · 2019Article
- Anesthetic management and associated complications of peroral endoscopic myotomy: A case series.World journal of gastrointestinal endoscopy · 2018Article
- Anesthesia in per-oral endoscopic myotomy: A large tertiary care centre experience.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2017Article
- Critical Analysis of Guidelines for Providing Sedation to Patients Undergoing Gastrointestinal Endoscopy Procedures.Anesthesia, essays and researchesReview
- Anesthesia for Per-oral endoscopic myotomy (POEM) - not so poetic!Journal of anaesthesiology, clinical pharmacologyReview
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeroral 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.
methodsIn this retrospective study, electronic charts of 24 patients who underwent POEM over 18 months were reviewed. Demographic data, fasting status, relevant aspiration risks, anesthetic technique, and postoperative care measures were extracted.
resultsFasting times for both solids and liquids were variable. None of the patients underwent preprocedural esophageal emptying. Standard induction and intubation were performed in 16, rapid sequence induction (RSI) with cricoid pressure in seven, and modified rapid sequence without application of cricoid pressure in one of the patients. One of the patients aspirated at induction, and the procedure was aborted. However, the procedure was performed successfully after a few weeks, this time a RSI with cricoid pressure was chosen.
conclusionAs there are no guidelines for the perioperative management of patients presenting for POEM presently, certain recommendations can be made. Preprocedural esophageal emptying should be considered in patients considered as high-risk, although cultural factors might preclude such an approach. Induction and intubation in a semi-reclining position might be useful. Although debatable, use of RSI with cricoid pressure should be strongly considered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.