Anesthesia for Esophageal Dilation Procedure in a World Gastroenterology Organizing Endoscopy Training Center
Somchai Amornyotin MD*, Siriporn Kongphlay BNS*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : The study is aimed to report and evaluate the choices and techniques, drugs used and complications of anesthesia
in the patients undergoing esophageal dilation procedure in a World Gastroenterology Organizing Endoscopy Training
Center in a developing country.
Material and Method: Retrospectively analyzed the patients on whom esophageal dilation procedure had been performed
during the period of December, 2010 to June, 2014 in a World Gastroenterology Organizing Endoscopy Training Center in
Thailand. The patients’ characteristics, pre-anesthetic problems, causes of stricture, anesthetic techniques, drugs, duration of
anesthesia, and anesthesia-related complications were assessed and summarized by using descriptive statistics.
Results : During the study period there were 223 procedures. The majority of ASA physical status classification was I (42.6%)
and II (48.0%). Most common pre-anesthetic problems were hematologic disease (19.3%), electrolyte imbalance (16.6%),
hypertension (13.0%) and diabetes mellitus (7.2%). Most common cause of stricture was corrosive esophagitis. Intravenous
sedation with and without topical anesthesia was the main anesthetic technique. The mainly used sedoanalgesic agents were
fentanyl, propofol and midazolam. The overall anesthesia-related complication rate was 18.4%. Hypotension (12.1%) was
the most frequent anesthetic complication.
Conclusion : All of the esophageal dilation procedures, intravenous sedation with or without topical pharyngeal anesthesia
could be performed safely and effectively in the appropriate patients. However, clinical signs should be carefully observed and
the anesthetic personnel had to optimize the patient’s condition for safety and be beware of complications.
Keywords : Anesthetic management, Esophageal dilation, Esophageal stricture, Efficacy, Safety, Endoscopic unit
