Perioperative Anesthesia: Botulinum Toxin Injection in a 6‐Year‐Old Female With “No Burp Disease”

Retrograde cricopharyngeus dysfunction is a chronic condition involving inability of the cricopharyngeal muscle to relax in a task‐specific manner (eructation). Symptoms commonly include bloating, significant discomfort, excessive flatulence, and often self‐imposed limitations in oral diet and activity. Here, we report a 6‐year‐old patient with several years of symptoms who underwent surgical injection of botulinum toxin under general anesthesia. Anesthesia with propofol and sevoflurane provided adequate sedation and analgesia. Nitrous oxide was avoided due to theoretical concern for impaired ability to clear esophageal and abdominal gas which can lead to postoperative nausea, vomiting, and aspiration risk.