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Related Experiment Videos

Upper oesophageal sphincter function during general anaesthesia

J P McGrath1, C McCaul, P J Byrne

  • 1University Department of Surgery, St James's Hospital, Dublin, Ireland.

The British Journal of Surgery
|September 1, 1996
PubMed
Summary
This summary is machine-generated.

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General anesthesia impairs the upper esophageal sphincter's ability to prevent acid reflux into the hypopharynx. Muscle relaxants further reduce sphincter tone, but do not increase acid exposure risk.

Area of Science:

  • Anesthesiology
  • Gastroenterology
  • Otolaryngology

Background:

  • The upper esophageal sphincter (UES) is crucial for preventing gastroesophageal refluxate aspiration.
  • General anesthesia's impact on UES function and its protective role against hypopharyngeal acid exposure remains incompletely understood.

Purpose of the Study:

  • To investigate the effect of general anesthesia on the UES response to acid.
  • To evaluate the influence of atracurium besylate (a muscle relaxant) on acid migration into the hypopharynx.

Main Methods:

  • A study involving 102 patients undergoing elective varicose vein surgery.
  • Patients were divided into two groups: one receiving general anesthesia with atracurium besylate, and the other with general anesthesia alone.
  • UES tone was measured using a 'sphinctometer', and acid reflux into the distal esophagus and hypopharynx was monitored.

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Main Results:

  • Patients receiving muscle relaxants exhibited significantly lower UES tone compared to those without (8 vs. 14, P < 0.05).
  • 16% of patients experienced distal esophageal reflux, with 7 reaching the hypopharynx; no significant difference was observed between groups.
  • UES tone did not change in response to reflux events in either group.

Conclusions:

  • General anesthesia compromises the protective function of the UES against acid reflux into the hypopharynx.
  • While muscle relaxants reduce UES tone, they do not alter the incidence of hypopharyngeal acid exposure in this context.