DOI: https://doi.org/10.36347/sasjm.2025.v11i11.007

Pages: 1112-1117

Peroral endoscopic myotomy (POEM) recently has been reported as minimally invasive therapy for esophageal achalasia requires general anesthesia. Postoperative nausea and vomiting (PONV) is one of the most common adverse events after general anesthesia. Although PONV is associated with adverse consequences undergoing POEM, little has been known about the incidence and risk factors. We evaluated the incidence of PONV undergoing POEM as well as the relationship between incidences and anesthetic agents. This prospective double-blind study comprised 60 patients with American Society of Anesthesiologist physical status I or II who were undergoing POEM with inhaled anesthesia or TIVA. Patients were interviewed by two experienced anesthesiologists about incidence of PONV in accordance with a categorical verbal rating scale (VAS) and PONV Intensity Scale. The primary outcome was the incidence of PONV undergoing POEM between the two groups. In addition, we observed postoperative outcomes including bleeding at surgical site, mucosal injury, and patients’ satisfaction. The incidence of PONV after POEM within first 6 hours was significant lower in the TIVA group than in the sevoflurane group (46.4% vs 76.7%, p=0.025). Additionally, it was observed that number of patients who experienced postoperative complications, such as surgical site injury, mucosal injury, heart burn, pneumoperitoneum, and emphysema, was higher in TIVA group (44.4%) compared with in sevoflurane group (26.7%), but it was insignificant (p=0.130). These data suggest that TIVA could be considered as a good method to prevent PONV during early postoperative period (within 6 hours) after POEM.