Effect of Parental Presence and Doctor's Conversation in Gastric Acidity and Volume Changes among Non - Crying Pediatric Surgical Patients

Kim, Jin Sung; Kim, Bong Il; Lee, Sang Hwa

Abstract

It has been already demonstrated by Cote and his collegues that the values of crying pts gastric pH were higher than those of noncrying pts. We have previously shown that the more patients cried, the higher gastric pH they had, and speculated that this effect may be resulted from the discharged stress through the crying. The present study was performed to examine the hypothesis that parental presence and doctors conversation prior to anesthesia influence the gastric acidity and volume changes. Ninety-one ASA class I or II children, 4 to 13 years of age, were selected randomly excluded 2nd or repeated operation, gastrointestinal operation and history of disease affecting gastric acidity and volume. And divided them into two groups by their status of parental presence and doctors conversation; parents presence (G-l, N=46) or not (G-2, N=45), doctor's comforting words(G-A, N=45) or not (G-B, N=46). These patients were further analyzed by combine factors of parental presence and doctors conversation; parental presence and doctors conversation (G-IA, N=25). parental presence and no conversation (G-1B, N=21), parent not present and conversation(G-2A, N=20) and parent not present and no conversation (G-2B, N=25). Those patients who had comforting words from their doctors were further divided by their response: poor response(G-i), good response(G-ii). All patients were premedicated with glycopyrrolate and hydroxyzine. Gastric samples were obtained through nasogastric tube and measured pH values with TOA pH METER MODEL HM-5ES(TOA Electronics Ltd., Tokyo, Japan) immediately after induction. The results were as follows; 1) Gastric pH; There were no statistical significances between groups(P>0.05) in the changes of the mean pH values. 2) Gastric volume; There were no statistical differences between groups(P>0.05) in the changes of the mean gastric volume(ml/kg). 3) Gastric pH and volume of the response of doctors conversation, There were no statistical difference of gastric pH and volume between good and poor response groups of doctors comfortmg words(P>0.05). From these results, we concluded that parental presence and doctors conversation did not influence the gastric acidity and volume statistically. However, clinically, these results might somehow influence the gastric acidity because the values of gastric pH of G-l(2.32+/-0.69) and G-A(2.38+/-0.64) were higher than of G-2(2.38+/-0.64) and G-B(2.18+/-0.53), and the value of gastric pH of G-IA(2.40+/-0.68) was highest and G-2B(2.15+/-0.43) was lowest.