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Gastroesophageal reflux during anaesthesia.

L Illing¹, P G Duncan, R Yip

¹Department of Anaesthesia, Royal University Hospital, Saskatoon, Saskatchewan.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie

|May 1, 1992

Summary

Gastroesophageal reflux (GER) during anesthesia is infrequent, occurring in 15.9% of patients. Straining on the endotracheal tube was linked to reflux, suggesting traditional risk factors may not predict aspiration risk.

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Area of Science:

Anesthesiology
Gastroenterology
Critical Care Medicine

Background:

Pulmonary aspiration risk is a concern in patients undergoing anesthesia, yet clinically significant aspiration incidence is low.
Traditional risk factors for vomiting and aspiration are often cited but may not accurately predict individual patient risk.

Purpose of the Study:

To determine the incidence of gastroesophageal reflux (GER) in patients under general anesthesia.
To correlate GER incidence with clinical variables including obesity, esophagitis history, bucking, and body position changes.

Main Methods:

Continuous esophageal pH monitoring was employed in 44 patients undergoing elective surgery.
GER was defined as reflux events with a pH value below 4.

Main Results:

Acid reflux (pH < 4) was detected in 7 out of 44 patients (15.9%) during anesthesia.
Reflux events were temporally associated with straining on the endotracheal tube in 6 patients (13.6%).

Conclusions:

The incidence of GER during general anesthesia is relatively low.
Straining on the endotracheal tube is a potential trigger for GER.
Conventional risk factors may not reliably predict which patients are at risk for regurgitation and aspiration.

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