Comparison of two topical treatments of gastro-oesophageal regurgitation in dogs during general anaesthesia

Abstract

ObjectiveTo determine whether suction, lavage and instillation of sodium bicarbonate, following a gastro-oesophageal regurgitation event under general anaesthesia, would alter oesophageal pH to a greater degree than when lavage was not used. Study designProspective, randomised, clinical study. AnimalsA group of 22 client-owned dogs. MethodsDogs presenting with gastro-oesophageal regurgitation (GOReg) under general anaesthesia were randomised into groups: no lavage (G1) or lavage (G2). All dogs underwent oesophageal suctioning until no further regurgitant material was retrieved. Dogs in G2 had oesophageal lavage with tap water until the suctioned water was clear. All dogs then had 4.2% sodium bicarbonate (0.6 mL kg–1) instilled into the oesophagus. An oesophageal pH probe was placed to record pH immediately after: GOReg (T1), suctioning (T2), lavage of the oesophagus (T3; G2 only) and sodium bicarbonate instillation (T4). Categorical data were analysed using Fisher’s exact test, and continuous data were analysed using either the two-sample t-test or the Wilcoxon rank-sum test. Parametric data are reported as mean ± standard deviation and non-parametric data as median (interquartile range). A p value < 0.05 was considered significant. ResultsOesophageal pH was low in both groups immediately after GOReg [G1: 2.95 (2.20–4.18), G2: 3.29 (1.41–4.03)] but oesophageal pH was not significantly different between groups at T1, T2 and T4. Oesophageal lavage significantly increased pH but the overall change in pH following bicarbonate administration (T2–T4) was not significantly different between groups [G1: 3.16 ± 1.52, G2: 3.52 ± 1.47]. No adverse events following GOReg were recorded. Conclusions and clinical relevance:Both groups had similar and clinically important increases in oesophageal pH. Although oesophageal lavage increased pH, this did not affect the final oesophageal pH when sodium bicarbonate was instilled and therefore may be an unnecessary step.