Abstract

Simple SummaryRegurgitation and gastro-oesophageal reflux (GOR) are common complications in dogs under anaesthesia. We reviewed the definitions and methods of GOR assessment in anaesthetized dogs published in 22 scientific papers to assess if studies were comparable (i.e., looking at the same thing). The definition of GOR implied the presence of fluids not reaching the mouth or nose in the oesophagus in all studies. Most studies measured the acidity in the oesophagus to state if fluids were present or not. The probes were not always placed in the same location and definitions varied. This means that it is complicated to compare findings of the different studies.We reviewed the definitions and methods of assessment of gastro-oesophageal reflux (GOR) in anaesthetized dogs. Three databases were used. Titles and abstracts were screened by two of the authors independently. A total of 22 studies was included in the analysis. The definition of GOR implied the presence of fluids not reaching the mouth or nose in the oesophagus in all studies. Most studies considered a change in pH using oesophageal pH meters as the sole method of assessment. Calibration of the pH probe was inconsistently reported. The position of the tip of the oesophageal probe was inconsistent and not always precisely described. The correct positioning in the intended location was verified in a limited number of studies. Some studies considered that GOR had happened for changes in pH below 4.0 or above 7.5 while others considered that GOR had happened when the pH dropped below 4.0 only. Some studies stated that the pH change had to be sustained for a minimum period of time (20 or 30 s) whereas others did not mention any duration. The variability of definitions and methods of assessment of GOR in anaesthetized dogs precludes meaningful comparison of the findings. Re-evaluation and uniformization of the methods appear necessary.

Highlights

  • Regurgitation and gastro-oesophageal reflux (GOR) are common complications in dogs undergoing general anaesthesia and can lead to significant morbidity and mortality.The literature highlights several risk factors and reports that the incidence of regurgitation and GOR may be influenced by a number of interventions

  • Before contrasting published findings and interventions aimed to reduce the development of regurgitation and GOR, it seems legitimate to question the methods used in the scientific literature

  • A total of 10/22 studies did not talk about regurgitation

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Summary

Introduction

Regurgitation and gastro-oesophageal reflux (GOR) are common complications in dogs undergoing general anaesthesia and can lead to significant morbidity and mortality.The literature highlights several risk factors (i.e., age, body weight, and type of surgery) and reports that the incidence of regurgitation and GOR may be influenced by a number of interventions (i.e., pre-operative fasting, positioning, and drugs). Reported incidences seem to vary reasonably for regurgitation [from 0.96% [1] to 5.5% [2],] but enormously for GOR [from 5% [3] to 87.5% [4]]. Such a huge variability is rather surprising. Before contrasting published findings and interventions aimed to reduce the development of regurgitation and GOR, it seems legitimate to question the methods used in the scientific literature. The aim of this study was to review the definitions and methods of assessment of GOR in anaesthetized dogs in clinical veterinary practice

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