Electrogastrographic changes in children who undergo day-surgery anesthesia

Background/Purpose: Postoperative nausea and vomiting is common after gener al anesthesia. The timing of resuming oral input is arbitrary. This study a ims to estimate the duration of emetic effects of general anesthesia after day surgery in children with electrogastrography (EGG). Methods: Children between the age of 3 and 12 years undergoing elective non abdominal surgery were recruited. The standard anesthesia protocol of thiop entone (5 mg/kg), O-2 (30%), N2O (70%), and isoflurane (1.5%) was adopted. Caudal block was applied to the patients. A laryngeal mask was used. A mobi le electrogastrogram (EGG) machine (Synectic; International Medtronic Synec tics, Stockholm, Sweden) was attached to the epigastrium of the patient at least 1 hour before the operation and the recording continued through the o peration and for a further 2 hours after the operation. The first half hour of preoperative recording was taken as normal control period. The results were analyzed using paired t test. Results: Twenty patients who underwent circumcision under general anesthesi a were studied. The mean age was 6.6 years. The mean anesthetic duration wa s 33.2 min. The tachygastria component (associated with nausea and vomiting ) became prominent immediately after induction and returned to normal 1 hal f hour after cessation of general anesthesia. The dominant frequency instab ility coefficient of EGG (DFIC) and the dominant power instability coeffici ent (DPIC) peaked during the first half hour period postoperatively and ret urned to baseline 1 hour postoperatively (DPIC, P >.05). Bradygastria becam e prominent during the periods 1 half-hour before and 1 half-hour after the general anesthesia and returned to baseline 1 hour postoperatively (P <.05 ). Conclusions Significant EGG changes occur during day-surgery general anesth esia for children undergoing nonabdominal surgery. These changes return to baseline 1 hour after reversal of anesthesia. It is probably safe to restar t feeding ? hour later after day-surgery general anesthesia without causing nausea and vomiting. J Pediatr Surg 34:1336-1338. Copyright (C) 1999 by W. B. Saunders Company.