Abstract
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
Highlights
30 dogs received metoclopramide – an intravenous bolus of 1 mg/kg 5 minutes before induction, and continuous infusion (1 mg/kg/h intravenously) immediately after anaesthetic induction
Objective study to evaluate the efficacy of maropitant for prevention of vomiting and GOR in dogs undergoing anaesthesia measuring oesophageal pH
Treatment Group 1 – 16 dogs received a low dose metoclopramide – bolus of 0.4 mg/kg intravenously followed by a continuous rate infusion of 0.3 mg/kg/hr before and during anaesthesia
Summary
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. The gastroprotectant used should be tailored to the patient and the clinical scenario presented (Marks et al, 2018)
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