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Updated: Oct 4, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Evaluation of Gastroesophageal Reflux in Children as a Risk for Post-operative Nausea and Vomiting: An Observational
Aslınur Sagun1, Handan Birbiçer2, Mustafa Azizoğlu2
1Department of Anesthesiology and Reanimation, Mersin University, School of Medicine, Mersin, Turkey.
Insights
This study found no significant link between gastroesophageal reflux (GER) and post-operative nausea and vomiting (PONV) in children undergoing appendectomy. Reflux was detected in some patients, but it did not correlate with PONV. Further research is needed.
Area of Science:
- Pediatric Anesthesiology
- Gastroenterology
- Surgical Outcomes
Background:
- Anesthesia can impair gastric emptying and motility, potentially leading to gastroesophageal reflux (GER).
- Monitoring esophageal pH is a validated method for detecting GER.
- The relationship between GER and post-operative nausea and vomiting (PONV) in pediatric surgical patients remains unclear.
Purpose of the Study:
- To investigate whether gastroesophageal reflux (GER) is a risk factor for post-operative nausea and vomiting (PONV) in pediatric patients undergoing laparoscopic appendectomy.
- To assess esophageal reflux using pH monitoring in this patient population.
Main Methods:
- A cohort of 55 pediatric patients undergoing laparoscopic appendectomy was studied.
- Esophageal pH monitoring was performed using a catheter placed above the lower esophageal sphincter.
- The DeMeester score was used to quantify acid reflux, with a score >14.7 indicating reflux. PONV was assessed using the Verbal Descriptive Scale (VDS).
Main Results:
- The study included 55 patients (41.8% girls, 58.2% boys) with a mean age of 13.2 years.
- Thirteen patients (23.6%) exhibited a DeMeester score >14.7, indicating acid reflux.
- No statistically significant association was found between the presence of reflux (DeMeester score) and the severity of PONV (VDS), gender, or fasting/operation times.
Conclusions:
- This study did not find a statistically significant association between gastroesophageal reflux and post-operative nausea and vomiting in pediatric patients undergoing laparoscopic appendectomy.
- While reflux was detected in a subset of patients, it did not correlate with PONV.
- Larger studies are recommended to further elucidate the potential relationship between GER and PONV in pediatric surgical settings.
Abstract:
1Background: Anaesthesia is known to reduce gastric emptying and motility, which can cause gastroesophageal reflux (GER) in some patients. Monitoring pH is a reliable method for detecting reflux. In this study, we aimed to show whether GER is a risk factor for post-operative nausea and vomiting (PONV) with oesophageal reflux measures in paediatric patients undergoing laparoscopic appendectomy.
Methods:
After obtaining approval from ethics committee, 55 paediatric patients were included. An oesophageal pH metre catheter was inserted through the nasal passage to 3 cm above the lower oesophageal sphincter. pH measurements were evaluated with DeMeester score. It was accepted as acid reflux if the score was >14.7. The patients' demographic data, history of GER and verbal descriptive scale (VDS) to assess PONV and pH values were analysed with Statistical Package for the Social Sciences (SPSS) version 21 (IBM SPSS Corp.; Armonk, NY, USA).
Results:
Of the 55 patients, 41.8% were girls, 58.2% were boys, the mean age was 13.2 years, the mean fasting period was 7.47 hours and the mean operation time was 1.1 hours. Mean fasting and operation times did not differ statistically according to VDS. There was no significant association between VDS group and gender or pH. None of the patients had a history of GER. Thirteen patients had DeMeester score >14.7.
Conclusion:
This is the first study about the relationship between gastric pH and PONV in paediatric patients. Although some studies have shown an association between anaesthesia and reflux, we detected reflux in nine of our patients and reflux was not statistically associated with PONV in our study. Further studies with larger patient groups are needed to provide a clearer opinion.
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