Effect of Propofol on Acid Reflux Measured with the Bravo pH Monitoring System

Area of Science:

• Pediatric Anesthesiology
• Gastroenterology

Background:

• Gastroesophageal reflux is a common concern in pediatric patients.
• The impact of anesthetic agents on acid reflux requires further investigation.

Purpose of the Study:

• To evaluate the effect of propofol on acid reflux in children.
• To assess the reliability of pH monitoring in the postanesthesia period.

Main Methods:

• Retrospective analysis of 48-hour Bravo pH monitoring data from 88 children.
• Comparison of reflux episodes and pH levels between day 1 and day 2 post-propofol administration.
• Analysis of both 6-hour and 24-hour segments.

Main Results:

• A significant increase in reflux episodes was observed in the first 6 hours of day 1 compared to day 2 (P = 0.006).
• A trend towards increased time with pH < 4 was noted in the initial 6 hours, but not statistically significant.
• No significant differences in reflux episodes or pH levels were found when comparing full 24-hour periods between day 1 and day 2.

Conclusions:

• Propofol may be associated with increased gastroesophageal reflux in the early postanesthesia period.
• Short-term pH monitoring (first 6 hours) after propofol may be unreliable for assessing reflux.
• Extended 48-hour pH monitoring is crucial for accurate gastroesophageal reflux assessment in these patients.