Peroral Endoscopic Myotomy (POEM)

Last updated: February 9, 2026

Access
PIV x1-2
Airway
Oral ETT
Induction
RSI
Maintenance
Gas and paralytic
Emergence
Awake
Antibiotics
None
Position
Standard (surgeons at head)

Notes

  • Positioning: Move anesthesia equipment to the far back right as surgeons will be at the head of the bed (0 degrees) with their scope.
  • Ventilation: CO₂ is used to insufflate the esophagus; increase minute ventilation (MV) to compensate.
  • Aspiration risk: RSI is recommended as the procedure is performed for achalasia or other esophageal pathologies that increase aspiration risk.