POEM (Peroral Endoscopic Myotomy) is an endoscopic procedure most commonly used to treat
achalasia. Achalasia is a disorder resulting from the inability of esophageal muscles to
relax.The POEM procedure, performed under general anesthesia, involves inserting an endoscope
into the esophagus where a specialized knife is able to cut a new pathway through the
esophageal tissue. The knife is then used to incise, and therefore loosen, tight muscles
within the esophagus, lower esophageal sphincter, and the upper region of the stomach that
are responsible for the symptoms.This study seeks to improve patient's post-operative pain
levels by placing ropivacaine (a local anesthetic) into the newly cut pathway that is created
in the POEM procedure. It is hypothesized that the topical irrigation of the POEM tunnel with
ropivacaine will result in decreased pain scores and a decreased need for additional pain
medications.