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Anesthetic Consideration for Peroral Endoscopic Myotomy

박정현|Yun-Sic Bang
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2019.11|Clinical Endoscopy|제52권 제6호|pp. 549-555|DOI 10.5946/ce.2019.033

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키워드

ComplicationPeroral endoscopic myotomyGeneral endotracheal anesthesia
주제분류내과학

초록

A recent achalasia guideline suggests that peroral endoscopic myotomy (POEM) is a safe option for achalasia that is as effective asHeller myotomy. It is recommended that POEM should be performed under general anesthesia. The incidence of adverse eventssuch as bleeding, perforation, and carbon dioxide insuffation-related complications was lower in POEM under endotracheal generalanesthesia than in POEM under sedation. Subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, andaccompanying hemodynamic instability can be caused by carbon dioxide insuffation. Treatment of possible physiological changesand adverse events during the POEM procedure from the point of view of anesthesiologists may give endoscopists a new perspectiveon 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 alsoexpand the area of treatment.

Abstract

A recent achalasia guideline suggests that peroral endoscopic myotomy (POEM) is a safe option for achalasia that is as effective asHeller myotomy. It is recommended that POEM should be performed under general anesthesia. The incidence of adverse eventssuch as bleeding, perforation, and carbon dioxide insuffation-related complications was lower in POEM under endotracheal generalanesthesia than in POEM under sedation. Subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, andaccompanying hemodynamic instability can be caused by carbon dioxide insuffation. Treatment of possible physiological changesand adverse events during the POEM procedure from the point of view of anesthesiologists may give endoscopists a new perspectiveon 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 alsoexpand the area of treatment.

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관련 논문AI추천

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