Effects of Malnutrition on Respiratory and Renal Functions in Patients Undergoing Peroral Endoscopic Myotomy (POEM)

Inclusion Criteria: * Criteria for inclusion in the study: * Patients diagnosed with achalasia and suitable for POEM treatment by gastroenterology physicians * ASA 1-3 * Between the ages of 18-80 Exclusion Criteria: * Criteria for exclusion from the study: * Those with a known history of active lung infection, advanced COPD, or respiratory failure * Patients with EF below 40%, severe ischemic heart failure, presence of valve disease * Those with bleeding diathesis and severe thrombocytopenia (limit 30-50 thousand) * severe kidney dysfunction * In the presence of known intolerance or allergy to certain medications for sedation, analgesia, or both * Pre-existing increased intracranial pressure * Having a BMI \>30 * Severe uncorrected hypovolemiaHistory of radiotherapy to the esophagus * History of mucosal resection or ablation in the area where POEM will be applied * Presence of cirrhosis and portal hypertension.