The Relationship between Intragastric and Lower Esophageal Sphincter Pressures during General Anesthesia

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Abstract
The mean resting intragastric pressure before skin incision was 9.8 .+-. 2.0 mm Hg, which is close to the mean resting intragastric pressure in conscious subjects. This decreased to 6.2 .+-. 1.0 mm Hg on opening the abdomen and increased to 17.1 .+-. 1.9 mm Hg after the abdomen was closed following administration of neostigmine and atropine. Before and after the abdomen was opened, the mean resting lower esophageal sphincter pressures were 20.2 .+-. 6.0 and 16.2 .+-. 48 mm Hg, respectively. This pressure increased to 26.2 .+-. 5.8 mm Hg after relaxant reversal. When the abdomen was opened, lower esophageal sphincter pressures in 2 patients were 7 mm Hg, and intragastric pressures, 5 mm Hg. Sudden manual gastric compression produced regurgitation in 1 of these 2 cases, in which intragastric pressure was 53 mm Hg. No regurgitation occurred in the remaining 14 cases, even though intragastric pressures in 7 were 108 mm Hg or higher. Regurgitation was proven by methylene blue dye which had been introduced into the stomach prior to manipulation. Before and after the abdominal cavity was opened, the correlation coefficients for intragastric pressure and lower esophageal sphincter pressure were highly significant: 0.75 and 0.62, respectively.

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