ArticleMedical devices (Auckland, N.Z.)2017
Peroral endoscopic myotomy: procedural complications and pain management for the perioperative clinician.
Article in Medical devices (Auckland, N.Z.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 31 citations in OpenAlex.
- Risk factors for esophageal pain after peroral endoscopic myotomy under general anesthesia: A retrospective study.World journal of gastrointestinal surgery · 2025Article
- Evaluation of Anesthesia Management During Peroral Endoscopic Myotomy in Patients with Achalasia: A Retrospective Study.Journal of clinical medicine · 2025Article
- Imaging following endoscopic and surgical treatment of achalasia.Abdominal radiology (New York) · 2025Review
- North American Expert Consensus on the Post-procedural Care of Patients After Per-oral Endoscopic Myotomy Using a Delphi Process.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Article
- Postoperative Pain Management Strategies Following Peroral Endoscopic Myotomy (POEM): A Review.Journal of pain research · 2025Review
- Oxycodone is superior to morphine for pain relief following peroral oesophageal myotomy: a prospective, randomized, controlled trial.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2022Article
- A Randomized Controlled Pilot Study of Topical Ropivacaine for Prevention of Post-POEM Pain.Journal of the Canadian Association of Gastroenterology · 2022Article
- High Eckardt score and previous treatment were associated with poor postperoral endoscopic myotomy pain control: A retrospective study.World journal of clinical cases · 2022Article
- Adverse Events Associated With Peroral Endoscopic Myotomy Affecting Extended Hospital Stay: A Multi-center Retrospective Study in South Korea.Journal of neurogastroenterology and motility · 2022Article
- Same-day discharge is safe and feasible following POEM surgery for esophageal motility disorders.Surgical endoscopy · 2021Article
- Paravertebral anesthetic nerve block for pain control after peroral endoscopic myotomy.Techniques and innovations in gastrointestinal endoscopy · 2021Article
- Peroral Endoscopic Myotomy as a Novel Treatment for Achalasia: Patient Selection and Perspectives.Clinical and experimental gastroenterology · 2020Review
- Esophageal POEM: the new standard of care.Translational gastroenterology and hepatology · 2020Review
- Problems in beginning a "POEM".Indian journal of anaesthesia · 2019Article
- Endoscopy and surgery for achalasia: the two sides of myotomy.Journal of thoracic disease · 2018Article
- Retrograde gastroesophageal intussusception after peroral endoscopic myotomy in a patient with achalasia cardia: A case report.Medicine · 2018Article
Corrections and comments
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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
Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus. The aim of our study is to document perioperative pain and associated pain management for our initial patients undergoing POEM and to review the literature for perioperative complications of this procedure. Therefore, anesthetic and pain management for our initial eleven patients undergoing POEM were reviewed. Patient demographics, pre-POEM pain medication history, perioperative pain medication requirements, and post-POEM pain scores were examined. We found post-POEM pain was usually in the mild-moderate range; a combination of medications was effective (opioids, nonsteroidal anti-inflammatory drugs, acetaminophen). Our literature search revealed a wide frequency range of complications such as pneumoperitoneum and subcutaneous emphysema, with rare serious events such as capnopericardium leading to cardiac arrest. In conclusion, our experience with POEM suggests pain and can be managed adequately with a combination of medications; the procedure appears to be safe and reasonable to perform in an outpatient endoscopy unit.
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