Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5655
Peer-review started: November 13, 2021
First decision: December 27, 2021
Revised: March 25, 2022
Accepted: April 4, 2022
Article in press: April 4, 2022
Published online: June 16, 2022
Processing time: 208 Days and 3.4 Hours
Postoperative pain management for peroral endoscopic myotomy (POEM) is often neglected by anesthesiologists because of the short operative time, short hospital stay and the minimally invasive nature of the procedure.
The authors conducted this retrospective study to examine the postoperative pain intensity of achalasia patients receiving the POEM procedure and to investigate possible risk factors for postoperative pain.
To achieve better postoperative pain management.
We included patients with achalasia who underwent POEM at Zhongshan Hospital from December 2017 to March 2018. The postoperative visual analog scale, postoperative sleep quality, basic patient information, and surgical parameters were collected.
The preoperative Eckardt score [odds ratio (OR): 1.82, 95% confidence interval (CI): 1.17-2.84, P < 0.001], previous treatment (OR: 7.59, 95%CI: 1.12-51.23, P = 0.037) and the distance between the end of the muscle incision and the cardia (OR: 1.52, 95%CI: 0.79-293.93, P = 0.072) were risk factors for post-POEM pain.
Achalasia patients who underwent POEM experienced serious postoperative pain, which may affect sleep quality. A higher Eckardt score, previous treatment, and a longer distance between the muscle incision ending and the cardia were risk factors for poor post-POEM pain control.
We will further explore the optimal approach to postoperative analgesia in patients who underwent POEM surgery in the randomized controlled trial study and will cooperate with endoscopists to explore the effect of the POEM modus operandi (intrapleural tunnel length and myotomy position) on postoperative pain.