Anaesthetic challenges of achalasia cardia

Abstract

Poor peristalsis and an inability to relax the lower esophageal sphincter are symptoms of achalasia cardia, a chronic neurodegenerative motility condition of the oesophagus. (LES). The primary problem with remedial operations for achalasia cardia is pulmonary aspiration of esophageal residual contents during induction of general anaesthesia. The timing of nil per oral or endoscopic clearance of esophageal contents prior to induction of anaesthesia is not governed by any universally accepted standards. We present the case of a 43-year-old man with a history of hypertension, diabetes, and myocardial infarction who underwent surgery to repair his sigmoid oesophagus. The patient was optimised before the anaesthesia was administered in accordance with the current standard of care. The patient's stay was uneventful, and there was no sign of aspiration during the operation. Aspiration during general anaesthesia was avoided by carefully optimizing the patient beforehand.