Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지
DOI QR코드

DOI QR Code

Anesthesia for Advanced Endoscopic Procedures

  • Basavana Goudra (Department of Anesthesiology and Critical Care Medicine, Hospital of the University of Pennsylvania) ;
  • Monica Saumoy (Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine)
  • Received : 2021.09.14
  • Accepted : 2021.10.18
  • Published : 2022.01.30
Download PDF
⟨ Previous Next ⟩

Abstract

The gastrointestinal endoscopy paradigm is rapidly changing, and technological advancements are largely responsible. In tandem, anesthesia providers are adapting to the changing needs and demands. The challenges are unique. Complications arising from the procedures are both routine, such as aspiration and hypoxia, and procedure specific, such as bleeding, pneumothorax, pneumopericardium, and pneumoperitoneum. It is crucial for the anesthesia provider to have a good understanding of the techniques employed by the endoscopist. A higher index of suspicion is also essential to diagnose and appropriately manage many of the complications. In this review, an effort is made to discuss both procedural aspects and anesthesia challenges. We hope that both endoscopists and anesthesia providers will benefit from this review.

Keywords

References

  1. Goh YM, James NE, Goh EL, Khanna A. The use of endoluminal techniques in the revision of primary bariatric surgery procedures: a systematic review. Surg Endosc 2020;34:2410-2428. https://doi.org/10.1007/s00464-020-07468-w
  2. Tawadros A, Makar M, Kahaleh M, Sarkar A. Overview of bariatric and metabolic endoscopy interventions. Ther Adv Gastrointest Endosc 2020;13:2631774520935239.
  3. de Moura DTH, de Moura EGH, Thompson CC. Endoscopic sleeve gastroplasty: from whence we came and where we are going. World J Gastrointest Endosc 2019;11:322-328. https://doi.org/10.4253/wjge.v11.i5.322
  4. Jain D, Bhandari BS, Arora A, Singhal S. Endoscopic sleeve gastroplasty - a new tool to manage obesity. Clin Endosc 2017;50:552-561. https://doi.org/10.5946/ce.2017.032
  5. Fox M, Hebbard G, Janiak P, et al. High-resolution manometry predicts the success of oesophageal bolus transport and identifies clinically important abnormalities not detected by conventional manometry. Neurogastroenterol Motil 2004;16:533-542. https://doi.org/10.1111/j.1365-2982.2004.00539.x
  6. Torres-Villalobos G, Martin-Del-Campo LA. Surgical treatment for achalasia of the esophagus: laparoscopic Heller myotomy. Gastroenterol Res Pract 2013;2013:708327.
  7. Goudra B, Singh P, Green M. Anaesthesia for uncommon and emerging procedures. New York (NY): Springer; 2021.
  8. Patel DA, Lappas BM, Vaezi MF. An overview of achalasia and its subtypes. Gastroenterol Hepatol (NY) 2017;13:411-421.
  9. Ali HA, Murali G, Mukhtar B. Respiratory failure due to achalasia cardia. Respir Med CME 2009;2:40-43. https://doi.org/10.1016/j.rmedc.2008.03.010
  10. Goudra B, Singh PM, Gouda G, Sinha AC. Peroral endoscopic myotomy-initial experience with anesthetic management of 24 procedures and systematic review. Anesth Essays Res 2016;10:297-300. https://doi.org/10.4103/0259-1162.171462
  11. Pandolfino JE, Kahrilas PJ. Presentation, diagnosis, and management of achalasia. Clin Gastroenterol Hepatol 2013;11:887-897. https://doi.org/10.1016/j.cgh.2013.01.032
  12. Ren Z, Zhong Y, Zhou P, et al. Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc 2012;26:3267-3272. https://doi.org/10.1007/s00464-012-2336-y
  13. Bang Y-S, Park C. Anesthetic consideration for peroral endoscopic myotomy. Clin Endosc 2019;52:549-555. https://doi.org/10.5946/ce.2019.033
  14. Okada T, Izuta S, Mizobuchi S. A case of ventilatory impairment during per-oral endoscopic myotomy under general anesthesia. JA Clin Rep 2018;4:23.
  15. Kiriyama S, Naitoh H, Kuwano H. Propofol sedation during endoscopic treatment for early gastric cancer compared to midazolam. World J Gastroenterol 2014;20:11985-11990. https://doi.org/10.3748/wjg.v20.i34.11985
  16. Song BG, Min YW, Cha RR, et al. Endoscopic submucosal dissection under general anesthesia for superficial esophageal squamous cell carcinoma is associated with better clinical outcomes. BMC Gastroenterol 2018;18:80.
  17. Goudra B, Singh PM. ERCP: the unresolved question of endotracheal intubation. Dig Dis Sci 2014;59:513-519. https://doi.org/10.1007/s10620-013-2931-3
  18. Basavana G. Goudra, Michael Duggan, Vidya Chidambaran, et al. Anesthesiology: a practical approach. New York (NY): Springer; 2018.
  19. Hauser G, Milosevic M, Zelic M, Stimac D. Sudden death after endoscopic retrograde cholangiopancreatography (ERCP)--case report and literature review. Medicine (Baltimore) 2014;93:e235.
  20. Wanderer JP, Nathan N. Bubble trouble: venous air embolism in endoscopic retrograde cholangiopancreatography. Anesth Analg 2018;127:324.
  21. Marchesi M, Battistini A, Pellegrinelli M, Gentile G, Zoja R. Fatal air embolism during endoscopic retrograde cholangiopancreatography (ERCP): an "impossible" diagnosis for the forensic pathologist. Med Sci Law 2016;56:70-73. https://doi.org/10.1177/0025802415594833
  22. Mathew J, Parker C, Wang J. Pulseless electrical activity arrest due to air embolism during endoscopic retrograde cholangiopancreatography: a case report and review of the literature. BMJ Open Gastroenterol 2015;2:e000046.
  23. Wills-Sanin B, Cardenas YR, Polanco L, Rivero O, Suarez S, Buitrago AF. Air embolism after endoscopic retrograde cholangiopancreatography in a patient with Budd Chiari syndrome. Case Rep Crit Care 2014;2014:205081.
  24. Lanke G, Adler DG. Gas embolism during endoscopic retrograde cholangiopancreatography: diagnosis and management. Ann Gastroenterol 2019;32:156-167. https://doi.org/10.20524/aog.2019.0339
  25. Fang Y, Wu J, Wang F, Cheng L, Lu Y, Cao X. Air embolism during upper endoscopy: a case report. Clin Endosc 2019;52:365-368. https://doi.org/10.5946/ce.2018.201
  26. Donepudi S, Chavalitdhamrong D, Pu L, Draganov PV. Air embolism complicating gastrointestinal endoscopy: a systematic review. World J Gastrointest Endosc 2013;5:359-365. https://doi.org/10.4253/wjge.v5.i8.359
  27. Thompson CC, Kumar N, Slattery J, et al. A standardized method for endoscopic necrosectomy improves complication and mortality rates. Pancreatology 2016;16:66-72. https://doi.org/10.1016/j.pan.2015.12.001
  28. Goudra BG, Singh PM, Gouda G, et al. Safety of non-anesthesia provider-administered propofol (NAAP) sedation in advanced gastrointestinal endoscopic procedures: comparative meta-analysis of pooled results. Dig Dis Sci 2015;60:2612-2627. https://doi.org/10.1007/s10620-015-3608-x