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Related Experiment Videos

Gastro-oesophageal reflux during elective laparoscopy.

C J Roberts1, N W Goodman

  • 1University Department of Anaesthesia, Southmead Hospital, Bristol.

Anaesthesia
|December 1, 1990
PubMed
Summary

Gastro-oesophageal reflux was not detected during gynaecological laparoscopy in 63 women. This suggests that routine tracheal intubation to prevent aspiration during these procedures may not be necessary.

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Area of Science:

  • Gastroenterology
  • Anaesthesiology
  • Gynaecology

Background:

  • Gastro-oesophageal reflux (GOR) is a concern during anaesthesia.
  • Laparoscopy involves pneumoperitoneum, which can increase intra-abdominal pressure and potentially exacerbate reflux.
  • The need for tracheal intubation to prevent aspiration during elective gynaecological laparoscopy is debated.

Purpose of the Study:

  • To investigate the incidence of gastro-oesophageal reflux during elective gynaecological laparoscopy.
  • To evaluate the necessity of tracheal intubation for aspiration prophylaxis in this patient population.

Main Methods:

  • Oesophageal pH monitoring was employed in 73 women undergoing elective gynaecological laparoscopy.
  • Data from 63 procedures were analyzed for reflux events.
  • Patients experiencing hiccups post-anaesthesia induction were noted separately.

Main Results:

  • No gastro-oesophageal reflux events were recorded in the 63 analyzed procedures.
  • The upper 95% confidence limit for reflux was 4.8% (3 in 63).
  • Two patients excluded from analysis experienced reflux during hiccups shortly after anaesthesia induction.

Conclusions:

  • Elective gynaecological laparoscopy appears to have a low risk of gastro-oesophageal reflux.
  • Routine tracheal intubation solely for aspiration prophylaxis during these procedures may not be indicated.
  • Further investigation into reflux during specific events like hiccups might be warranted.

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