Zhao X, Li ST, Chen LH, Liu K, Lian M, Wang HJ, Fang YJ. Identification of independent risk factors for intraoperative gastroesophageal reflux in adult patients undergoing general anesthesia. World J Clin Cases 2021; 9(35): 10861-10870 [PMID: 35047597 DOI: 10.12998/wjcc.v9.i35.10861]
Corresponding Author of This Article
Shi-Tong Li, MD, Academic Fellow, Anesthesiology Department, Shanghai General Hospital of Nanjing Medical University, No. 100 Haining Road, Hongkou District, Shanghai 200000, China. lishitongs021@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2021; 9(35): 10861-10870 Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10861
Identification of independent risk factors for intraoperative gastroesophageal reflux in adult patients undergoing general anesthesia
Xiao Zhao, Shi-Tong Li, Lian-Hua Chen, Kun Liu, Ming Lian, Hui-Juan Wang, Yi-Jiao Fang
Xiao Zhao, Shi-Tong Li, Lian-Hua Chen, Kun Liu, Ming Lian, Hui-Juan Wang, Anesthesiology Department, Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China
Yi-Jiao Fang, Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Yi-Jiao Fang, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Author contributions: Zhao X and Wang HJ conceived and coordinated the study, designed, performed, and analyzed the experiments, and wrote the paper; Liu K, Wang HJ, Liu K, Li ST, Chen LH, and Fang YJ carried out the data collection and data analysis and revised the paper. All authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the ethics committee of Shanghai General Hospital (2019KY037).
Informed consent statement: Informed consent was waived by the committee because of the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data set supporting the results of this article are included within the article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Tong Li, MD, Academic Fellow, Anesthesiology Department, Shanghai General Hospital of Nanjing Medical University, No. 100 Haining Road, Hongkou District, Shanghai 200000, China. lishitongs021@163.com
Received: May 22, 2021 Peer-review started: May 22, 2021 First decision: June 28, 2021 Revised: July 25, 2021 Accepted: September 16, 2021 Article in press: September 16, 2021 Published online: December 16, 2021 Processing time: 201 Days and 21.3 Hours
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.
