Effect of the Amount of Crying on the Gastric Acidity and Volume in Pediatric Surgical Patients

Kim, Bong Il; Park, Chan Hong; Lee, Sang Hwa

Abstract

It has been already demonstrated that the gastric acidity of crying pediatric surgical patients were less acidic than that of non-crying patients by Cote CJ and his collegues. Under the postulation that the changes of the gastric acidity and volume of crying patients might not be the same according to the amount of crying(duration or crying), this study was undertaken. 81 ASA physical status 1-2 children ages 1-14 for 1st elective operation except gastrointesti- nal surgery were selected randomly and divided into 2 groups and subdivided into 2 groups as follows: Group 1 (n=39~7, not cried Group 2 (n=42g cried Group A (n=14R cried in RR and OR Group B (n=28); cried in OR Subgoup B-1 (n= 11~7, cried as soon as arrived in OR Subgroup B-2 (n = 17); cried when attached monitoring and/or started IV 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-SES immediately after induction. The results were as follows; 1) Gastric pH In the changes of the mean pH values, there were statistical significances between groups 1 and 2(P<0.01), and between groups A and B(P<0.05), but was no statistical difference between subgroups B-1 and B-2. In comparing group A with subgroups B-1 or B-2, there was no statistcal significance between group A and subgroup B-l, but there was statistical signifi- cance between group A and subgroup B-2(P<0.05). 2) Gastric volume In the changes of the mean gastric volume(ml/kg), there were no statistical differences be- tween groups 1 and 2 and between groups A and B, but there was statistical significance be-tween subgroup B-l and B-2(P<0.05). In comparing group A with subgroups B-1 or B-2, there was no statistacal significance between group A and subgroup B-l, but there was statistically significance between group A and subgroup B-2(P<0.05). 3) Combined risk of pH and volume There were no differences in the proportion of combined risk(both gastric pH C2.5 and Ras- tric volume > or = 0.4 ml/kg) between groups 1 and 2, and between subgroups B-1 and B-2, but there were significant differences between groups A and B, and between group A and subgroup B-2 (p <0.05).