ABSTRACT

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.

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).

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.

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.

Keywords: Gastroesophageal refluxpost-operative nausea and vomitingappendectomy