Publication:
Challenges in anesthesia management for peroral endoscopic myotomy: a retrospective analysis

dc.contributor.coauthorYurtlu, Derya A.
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorAslan, Fatih
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T23:26:28Z
dc.date.issued2021
dc.description.abstractBackground: Peroral endoscopic myotomy (POEM) is used to treat achalasia with efficacy and reliability. However, during the procedure potential complications require attention in terms of anesthesia. This study aimed to investigate complications of the POEM procedure and its effects on arterial blood gas (ABG) parameters, peak airway pressures (PIP), hemodynamics, and postoperative analgesia requirements. Methods: Data from 220 patients who underwent POEM between 2014 and 2017 were retrospectively assessed. During the procedure, ABG samples, PIP, mean arterial pressure, and heart rate were recorded. The effects of the procedure and paracentesis on ABG, PIP, mean arterial pressure, heart rate, perioperative complications, and postoperative analgesia requirements were assessed. Results: Data from 220 POEM patients were analyzed. During the procedure, the mean PaCO2 was 48.27 +/- 6.34 mm Hg, which was significantly higher than the PaCO2 values before and after the procedure. The mean increase in maximum PIP was 5.90 +/- 3.49 cmH(2)O during the procedure. However, there was a significant decrease in PaCO2 and PIP values in cases with paracentesis compared with those without paracentesis. With regards to complications, subcutaneous emphysema (48, 21.8%), pneumoperitoneum requiring decompression (66, 30%), pneumothorax (1, 0.5%), aspiration pneumonia (1, 0.5%), and bronchospasm (5, 2.2%) were observed during the procedure. In the postoperative period, 58 patients (26%) had additional analgesia requirements because of visual analog scale values >3. Conclusion: Periprocedural abdominal decompression with veress needle led to a reduction in arterial PaCO2 and PIP, and improved postoperative analgesia. Serious complications because of perioperative aspiration and CO2 insufflation were observed during the POEM procedure.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue6
dc.description.openaccessNO
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume31
dc.identifier.doi10.1097/SLE.0000000000000978
dc.identifier.eissn1534-4908
dc.identifier.issn1530-4515
dc.identifier.scopus2-s2.0-85120852991
dc.identifier.urihttps://doi.org/10.1097/SLE.0000000000000978
dc.identifier.urihttps://hdl.handle.net/20.500.14288/11557
dc.identifier.wos725693600013
dc.keywordsPeroral endoscopic myotomy
dc.keywordsAchalasia
dc.keywordsAnesthesia
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofSurgical Laparoscopy Endoscopy & Percutaneous Techniques
dc.subjectSurgery
dc.titleChallenges in anesthesia management for peroral endoscopic myotomy: a retrospective analysis
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorAslan, Fatih
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
relation.isParentOrgUnitOfPublication.latestForDiscovery17f2dc8e-6e54-4fa8-b5e0-d6415123a93e

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