Consensus on the Management of Anesthetic Agents During Digestive Motility Measurements and Proposal of a Standardized Protocol for Anesthesia (French Neuro Gastroenterology Group GFNG and Committee of Anesthetic French Experts)

Neurogastroenterol Motil. 2025 Jun 18:e70098. doi: 10.1111/nmo.70098. Online ahead of print.

Abstract

Introduction: Techniques for measuring digestive motility are becoming increasingly precise and enable therapeutic interventions. However, while most of these interventions require general anesthesia, there is limited data on the impact of anesthetic agents on these measurements, and no standardized anesthesia protocol currently exists to guide such procedures. Our working group carried out two Delphi processes involving experts in neurogastroenterology and anesthesiology to reach a consensus on which drugs affect these measurements and to establish an anesthesia protocol.

Method: Two expert groups were formed, comprising 13 neurogastroenterology experts from the French Neuro-Gastroenterology Group (GFNG) and 15 full- or associate professors in anesthesia and intensive care. The first Delphi process involved the neurogastroenterologists and aimed to identify which anesthetic drugs influenced digestive pressure measurements. The second Delphi process, involving anesthetists, sought to develop an anesthesia protocol. Each expert indicated their level of agreement with each statement using a 6-point Likert scale. A statement was endorsed when at least 80% of experts agreed with it. The strength of evidence for each statement was evaluated using the GRADE system.

Results: The Delphi process with neurogastroenterologists was conducted over three rounds and ultimately resulted in 91 amendments. The second Delphi process with anesthetists took place over two rounds and included 28 amendments, leading to the development of an anesthesia protocol.

Conclusion: To our knowledge, this work is the first to establish an expert consensus on anesthetic agents that can affect digestive motility measurements and to propose an anesthesia protocol that accounts for the needs of neurogastroenterologists.

Keywords: Delphi; FLIP; anesthesia protocol; digestive motility; experts groups; manometry.