{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:25:37Z","timestamp":1777379137593,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100020541","name":"Royal Adelaide Hospital Research Fund","doi-asserted-by":"publisher","award":["Project Grant"],"award-info":[{"award-number":["Project Grant"]}],"id":[{"id":"10.13039\/501100020541","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004267","name":"royal adelaide hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004267","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    Remifentanil and dexmedetomidine are sedative agents used both in anaesthetic and critical care practice. Their effects on the gastro-oesophageal pressure gradient and hence on the potential risk for regurgitation have not been quantified. The aim of this study was to measure and compare the effects of both agents on the gastro-oesophageal pressure gradient. The study used a randomised, double blinded crossover study design, and 16 healthy volunteers were sedated on two separate occasions. Baseline lower oesophageal sphincter pressure (26 and 28 mmHg for dexmedetomidine and remifentanil, respectively) and gastro-oesophageal pressure gradient (20 mmHg for both dexmedetomidine and reminfentanil) were recorded. Then, each volunteer received increasing doses of target-controlled infusions of dexmedetomidine (1, 2, 4, 6 ng\/ml) or remifentanil (1, 2, 3, 4 ng\/ml). Each dose level was maintained for 20 minutes, and both lower oesophageal sphincter pressure and gastro-oesophageal pressure gradient were continuously recorded. Measurements were averaged. Out of 16 subjects recruited, data were analysable from 11 (aged 18\u201354 years, body mass index 17.7\u201327.9 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , five men and six women). The dose regimens of both agents provided similar profiles of progressive sedation over time, with sedation scores reaching a minimum of \u22122 on the \u2018observer\u2019s assessment of alertness and sedation score\u2019 with both medications. With dexmedetomidine, the bispectral index gradually decreased in line with sedation scores (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.05), but remifentanil produced little change in the bispectral index from baseline. Both agents decreased gastro-oesophageal pressure gradient (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.001) similarly, (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    =0.199), in line with the decreases in sedation scores. In conclusion, when remifentanil or dexmedetomidine are administered to provide sedation they induce similar decreases in gastro-oesophageal pressure gradient. This may put patients at comparable risk of gastro-oesophageal reflux.\n                  <\/jats:p>","DOI":"10.1177\/0310057x251379094","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T04:47:33Z","timestamp":1765774053000},"page":"133-139","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effects of remifentanil and dexmedetomidine on the gastro-oesophageal pressure gradient: A crossover randomised controlled volunteer trial"],"prefix":"10.1177","volume":"54","author":[{"given":"Islam M","family":"Elhalawani","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7620-5577","authenticated-orcid":false,"given":"Adam M","family":"Deane","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Melbourne Hospital, Parkville, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy L","family":"Ludbrook","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard W","family":"Watts","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Champion","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard H","family":"Holloway","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0707-0063","authenticated-orcid":false,"given":"Ryan DF","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline E","family":"Cousins","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne J","family":"Chapman","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2007.03.003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-2707-5"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/81.4.537"},{"key":"e_1_3_2_5_2","first-page":"707","article-title":"\u201cSilent\u201d regurgitation and aspiration during general anesthesia","volume":"49","author":"Blitt CD","year":"1970","unstructured":"Blitt CD, Gutman HL, Cohen DD, et al. \u201cSilent\u201d regurgitation and aspiration during general anesthesia. 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