Characteristics of general anesthesia of esophageal tumor patients undergoing endoscopic operation

Objective To summarize the experiences with general anesthesia of esophageal tumor patients undergoing peroral endoscopic myotomy (POEM) and endoscopic submucosal dissection (ESD) and the management of complications. Methods Clinical data about 82 patients who underwent POEM and 214 esophageal tumor patients who underwent ESD in our center from December 2008 to March 2013 were retrospective analyzed. Results General anesthesia of the 296 patients was induced by slow tracheal intubation amnesia analgesia. The anesthesia was maintained with combined intravenous propofol and intermittent intravenous fentanyl. The mean ESD and POEM time was 62.8±12.51 min and 78.6±15.42 min, respectively. After the anesthetic tube was removed, the transient systolic blood pressure was lower than 80 mmHg in 32 patients (10.91%), the intra-operative systolic blood pressure decreased by 20% in 8 patients (2.7%), bronchospasm occurred in 1 patient (0.3%), pneumothorax developed in 3 patients (1%), subcutaneous emphysema was observed in 12 patients (4%), pneumoperitoneum was detected in 1 patient (0.3%), arrhythmia was found in 26 patients (8.78%). Conclusion The anesthetic efficiency of general anesthesia induced by slow tracheal intubation amnesia analgesia is good for operation. Complications such as pneumothorax should be promptly diagnosed and treated.