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Anesthesia for esophageal surgery

Author
Jennifer Macpherson, MD
Section Editor
Peter D Slinger, MD, FRCPC
Deputy Editor
Nancy A Nussmeier, MD, FAHA

INTRODUCTION

This topic will discuss anesthetic management of elective and urgent esophageal surgery, both open and endoscopic. Challenges include increased risks for pulmonary aspiration, possible need for one lung ventilation, and postoperative pain management.

Anesthetic techniques for esophagoscopy are reviewed separately. (See "Anesthesia for gastrointestinal endoscopy in adults".)

PREANESTHETIC PLANNING

Preanesthetic planning for esophageal surgery includes:

Minimizing risk of pulmonary aspiration. Many patients with esophageal disease have a high risk of pulmonary aspiration due to esophageal mass, stricture, or achalasia. Precautions for a full stomach are always employed since esophageal contents are unknown and retained ingested food may be present even after an appropriate fasting period. If general anesthesia is planned, these precautions include a rapid sequence induction and intubation (RSII) technique or awake endotracheal intubation. (See "Anesthesia for gastrointestinal endoscopy in adults", section on 'Airway management'.).

Assessing the airway. If necessary, prepare to manage a difficult airway. (See "Management of the difficult airway for general anesthesia".)

                                  

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Literature review current through: Mar 2017. | This topic last updated: Mar 31, 2017.
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