Identification of independent risk factors for intraoperative gastroesophageal reflux in adult patients undergoing general anesthesia

ARTICLE HIGHLIGHTS

Research background

Gastroesophageal reflux (GER) is the most likely complication in perioperative patients, and early detection, diagnosis, and treatment can prevent serious adverse consequences.

Research motivation

No previous study had investigated the independent risk factors for the risk of GER and total GER time for patients undergoing general anesthesia.

Research objectives

To explore independent risk factors for the incidence and extent of GER during general anesthesia induction.

Research methods

This is a retrospective study, and 601 adult patients who received general anesthesia intubation or laryngeal mask surgery were involved. The definition of GER was based on assessment by Orion II-ohmega portable pH dynamic monitoring recorder, which was used to monitor the pH of the middle and lower esophagus to observe whether reflux occurred and to measure the occurrence frequency and duration. The potential risk factors for the incidence of GER were explored using multivariate logistic regression, and the risk factors for the extent of GER were evaluated using multivariate linear regression.

Research results

This study found female sex, increased age, pharyngitis, and history of GER were associated with an increased risk of GER, whereas the use of propofol could protect against the risk of GER. Moreover, age, operative time, pharyngitis, history of GER, and hypertension were significantly associated with GER time.

Research conclusions

This study identified the risk factors for the incidence of GER in patients undergoing general anesthesia, including female sex, increased age, pharyngitis, and history of GER.

Research perspectives

Further prospective studies should be performed to verify these findings owing to the retrospective design of this study.