DOI
https://doi.org/10.18849/ve.v5i4.340Abstract
PICO question
In dogs undergoing anaesthesia do pre-anaesthetic gastroprotectants reduce gastro-oesophageal reflux?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Five papers were critically reviewed. There was a randomised prospective study, two randomised blinded prospective studies, randomised non-blinded prospective study and a randomised, double blinded and placebo-controlled prospective study.
Strength of evidence
Moderate
Outcomes reported
Evidence of high quality suggests omeprazole or cisapride with esomeprazole decrease the incidence of gastro-oesophageal reflux (GOR) in the anaesthetised dog. In addition, a study of lower quality showed that continuous infusion of metoclopramide at a higher than normal dose rate decreased the incidence of GOR.
Conclusion
Omeprazole or cisapride with esomeprazole decreases the incidence of GOR in the anaesthetised dog.
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care
References
Downing, F. & Gibson, S. (2018). Anaesthesia of brachycephalic dogs. Journal of Small Animal Practice, 59(12), 725–733. DOI: https://doi.org/10.1111/jsap.12948
Favarato, L. S. C., Favarato, E. S., Souza, M. V., Costa, P. R. S., Nehme, R. C., Monteiro, B. S. & Bonfá, L. P. (2012). Evaluation of metoclopramide and ranitidine on the prevention of gastroesophageal reflux episodes in anesthetized dogs. Research in Veterinary Science, 93(1), 466–467. DOI: https://doi.org/10.1016/j.rvsc.2011.07.027
Johnson, R. A. (2014). Maropitant prevented vomiting but not gastroesophageal reflux in anesthetized dogs premedicated with acepromazine-hydromorphone. Veterinary Anaesthesia and Analgesia, 41(4), 406–410. DOI: https://doi.org/10.1111/vaa.12120
Marks, S. L., Kook, P. H., Papich, M. G., Tolbert, M. K. & Willard, M. D. (2018). ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats. Journal of Veterinary Internal Medicine, 32(6), 1823–1840. DOI: https://doi.org/10.1111/jvim.15337
NOAH Compendium (NOAH). (2020). Emeprid, clinical particulars.
Panti, A., Bennett, R., Corletto, F., Brearley, J., Jeffrey, N. & Mellanby, R. (2009). The effect of omeprazole on oesophageal pH in dogs during anaesthesia. Journal of Small Animal Practice, 50(10), 540–544. DOI: https://doi.org/10.1111/j.1748-5827.2009.00818.x
Rodríguez-Alarcón, C., Beristain-Ruiz, D., Rivera-Barreno, R., Díaz, G., Usón-Casaús, J., García-Herrera, R., Pérez-Merino, E., Universidad Autónoma de Ciudad Juárez & Universidad de Extremadura. (2015). Gastroesophageal reflux in anesthetized dogs: a review. Revista Colombiana de Ciencias Pecuaria, 28(2), 144–155. DOI: https://doi.org/10.17533/udea.rccp.v28n2a03
Wilson, D., Evans, A. & Mauer, W. (2006). Influence of metoclopramide on gastro-esophageal reflux in anesthetized dogs. American Journal of Veterinary Research, 67(1), 26–31. DOI: https://doi.org/10.2460/ajvr.67.1.26
Wilson, D., Evans, A. & Miller, R. (2005). Effects of preanesthetic administration of morphine on gastroesophageal reflux and regurgitation during anesthesia in dogs. American Journal of Veterinary Research, 66(3), 386–390. DOI: https://doi.org/10.2460/ajvr.2005.66.386
Zacuto, A. C., Marks, S. L., Osborn, J., Douthitt, K. L., Hollingshead, K. L., Hayashi, K., Kapatkin, A. S., Pypendop, B. H. & Belafsky, P. C. (2012). The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs. Journal of Veterinary Internal Medicine, 26(3), 518–525. DOI: https://doi.org/10.1111/j.1939-1676.2012.00929.x
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Copyright (c) 2020 Leanne Barry
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