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928
Sevoflurane Dose and Timing Affects Esophageal Contractility During Functional Lumen Imaging Probe.
Erin E Toaz1, Alain J Benitez2, Eric C Cheon1
1Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
The American Journal of Gastroenterology
|December 19, 2025
Summary
Anesthesia with sevoflurane significantly impacts esophageal contractile response (CR) in children undergoing functional lumen imaging probe (FLIP) testing. Higher sevoflurane doses and specific timing are linked to abnormal CR, affecting dysphagia evaluations.
Area of Science:
- Pediatric Gastroenterology
- Anesthesiology
- Esophageal Physiology
Background:
- Functional lumen imaging probe (FLIP) assesses esophageal contractile response (CR).
- Anesthetic agents can alter esophageal contractility during endoscopy.
- The specific effects of anesthetics on pediatric esophageal CR are not well understood.
Purpose of the Study:
- To investigate the association between anesthetic administration and esophageal CR in pediatric patients undergoing FLIP.
- To determine if sevoflurane dose and timing affect esophageal CR during FLIP procedures.
Main Methods:
- Retrospective review of pediatric patients (3-22 years) undergoing FLIP for dysphagia.
- Analysis of anesthetic dose, timing, and FLIP-derived CR.
- Logistic regression to assess the impact of sevoflurane on absent CR; comparison of end-tidal sevoflurane concentrations.
Main Results:
- 80% of 303 pediatric patients had abnormal esophageal CR.
- Sevoflurane administration was associated with an 8.4-fold increased odds of absent CR (P < 0.001).
- Higher sevoflurane use and end-tidal concentrations were observed in patients with abnormal CR.
Conclusions:
- Anesthetic timing and sevoflurane dosage are strongly associated with impaired esophageal CR during FLIP in children.
- Findings highlight the need to consider anesthetic effects when interpreting FLIP results in pediatric dysphagia evaluations.
