Effects of sevoflurane and enflurane on lower esophageal sphincter pressure and gastroesophageal pressure gradient in children

Journal of Anesthesia
A KohjitaniH Obara

Abstract

The effects of sevoflurane and enflurane on the intraluminal pressure of the lower esophagus (LE), lower esophageal sphincter (LES), and stomach were investigated in paralyzed and mechanically ventilated children under general anesthesia. A total of 14 children, ASA physical status class I without risk factors for regurgitation, scheduled for orthopedic surgery were studied. After induction of anesthesia, we inserted a gastrointestinal pressure sensor nasally and monitored the intraluminal pressure of the LE, LES, and stomach under various concentrations of sevoflurane or enflurane with 66% nitrous oxide in oxygen prior to surgical incision. The barrier pressure (BrP), which is the difference between LES pressure and intragastric pressure, was calculated. Sevoflurane at 2.0 and 2.5 minimum alveolar concentration (MAC) decreased LES pressure, and enflurane at 2.0 and 2.5 MAC decreased both LES pressure and BrP in anesthetized children. The intraluminal pressure of the LE and stomach were not altered in either group. Sevoflurane and enflurane have an inhibitory effect on LES smooth muscle in anesthetized children. However, since the reduction was relatively low, even at high concentrations, these inhalation anesthetics are unlike...Continue Reading

Citations

Nov 3, 2006·American Journal of Veterinary Research·Deborah V WilsonA Tom Evans
Feb 10, 2007·The Journal of Physiology·James G BrasseurLarry S Miller
Jan 1, 2016·Journal of Pediatric Gastroenterology and Nutrition·Christine Waasdorp HurtadoRobert E Kramer
Dec 16, 2010·European Journal of Anaesthesiology·Beatrice Beck-Schimmer, John M Bonvini
Apr 18, 2019·Current Opinion in Anaesthesiology·Hiroaki MurataTetsuya Hara

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