Experience in the anesthetic management of patients undergoing enteroscopy with powerspiral.

Abstract

Introduction: The implementation of motorized spiral enteroscopy (MSE) in digestive endoscopy units required the upgrading of assistencial guidelines to perform general anesthesia with orotracheal intubation in a systematic and safe manner.

Objective: To describe the anaesthetic management during MSE and to evaluate the incidence of complications during and within 24 hours after the procedure. To assess whether there is a relationship between the difficulty of inserting and withdrawing the MSE and the patient's airway characteristics.

Patients and methods: Observational, prospective study in patients undergoing anterograde MSE under GA in our endoscopy unit between 2021 and 2023. We recorded clinical and demographic, and airway characteristics. We registered the anesthesia and MSE procedure, as well as the peri-procedure complications within 24 hours.

Results: After excluding one patient due to a full stomach, 49 patients were included (mean age 63±14 years, 53% women, 41% ASA III-IV). All underwent total intravenous general anesthesia and orotracheal intubation, with a 12% incidence of difficult VA. The incidence of anaesthetic complications was 4%, with no serious events. 18% had difficulties in inserting and/or withdrawing the MSE and 33% had difficult airway. During recovery, 46% had sore throat and VAS >3 in 31%. At 24 hours, VAS >3 persisted in 47% of cases.

Conclusions: Motorized spiral enteroscopy under GA in the endoscopy unit is a safe procedure, with a low incidence of serious complications. Multidisciplinary collaboration and preanesthetic assessment are essential to minimize risk.