Gastro-Oesophageal Reflux and Adverse Respiratory Events in Children under Anaesthesia

Abstract

The incidence of gastro-oesophageal reflux in children undergoing general anaesthesia has not previously been studied. Onehundred-and-twenty children (ASA Class 1-2) were studied intraoperatively using continuous oesophageal pH monitoring. The incidence of reflux was 2.5% (3 of 120). None of these three patients had an adverse respiratory event. There was no correlation between reflux and adverse respiratory events. Thirteen patients had minor respiratory events without evidence of acid reflux. Gastro-oesophageal reflux does occur in healthy paediatric patients having minor surgery, but was not a significant cause of the adverse respiratory events that occurred in our study.

Investigation of gastric pepsinogen in middle ear fluid of children with glue ear

“…However, Milross et al investigated the incidence of gastroesophageal reflux in 120 children undergoing general anaesthesia by means of intraoperative continuous esophageal pH monitoring. The incidence of reflux was 2.5% (3 of 120) [13].…”

Aspiration and regurgitation prophylaxis in paediatric anaesthesia

“…However, silent pulmonary aspiration may be more frequent and has been reported from 2.5% (6) to almost 80% (7) with various detection methods. Data on the pulmonary aspiration and its associated morbidity and mortality are scarce and the effects of prevention of aspiration are not available (1).…”

Klinischer Einsatz der ProSeal®-Kehlkopfmaske bei Säuglingen, Kindern und Jugendlichen

“…Die Inzidenz von >1% erscheint relativ hoch, da doch die Inzidenz an klinisch offenkundigen Regurgitationen der CLMA auf der Basis von Metaanalysen als <0,1% angesehen werden kann [17]. Allerdings konnte mithilfe des kontinuierlichen ösophagealen pH-Monitorings belegt werden, dass die Rate an gastroösophagealem Reflux bei gesunden Kindern bis zu 2,5% betragen kann [15]. Eine mögliche Erklärung für die relativ hohe Inzidenz an offenkundiger Regurgitation könnte daher sein, dass selbst die CLMA eine Art Schutz leistet, indem der freie Fluss von regurgitierter Flüs-sigkeit durch die distale Spitze des Cuffs der CLMA im oberen Ösophagussphink-…”