Abstract
Gastroesophageal reflux (GER) is a common event during general anaesthesia but is often underdiagnosed in veterinary medicine. The oesophageal pH in anaesthetised dogs undergoing endoscopic evaluation of the upper gastrointestinal tract (END group; n = 12) or orthopaedic surgery (ORT group; n = 12) was measured using an oesophageal probe. The dogs were sedated with acepromazine or with methadone or butorphanol, and anaesthesia was induced with propofol and maintained with isoflurane. Of the 24 dogs in this study, 21 (87.5%) had an episode of GER during anaesthesia. The incidence of GER, as well as the first, the minimum, and the maximum pH values, did not differ significantly between the groups. The mean maximum difference versus the first pH value was higher for dogs in the END group (−2.6 ± 3.5) as compared with those in the ORT group (−0.7 ± 2.5), although they were not statistically significant (p = 0.25). The administration of methadone or butorphanol had no significant effect on the development of acidic reflux or biliary reflux. In the acepromazine-sedated dogs, the incidence of GER did not differ significantly between patients undergoing an endoscopic procedure and those undergoing orthopaedic surgery; however, during endoscopy, fluctuations in the oesophageal pH can be expected, even without any clinical signs of GER.
Highlights
Reflux of gastric content into the oesophagus is a common event in humans and in veterinary patients undergoing general anaesthesia
The incidence of Gastroesophageal reflux (GER) in dogs undergoing upper gastrointestinal endoscopy was evaluated for the first time, and the results were compared with those obtained in dogs undergoing a non-abdominal surgical procedure
The oesophageal pH value during a gastroenteroscopy has never been evaluated in dogs, the results from previous studies involving dogs during surgery have suggested that the incidence of GER is higher in dogs undergoing abdominal procedures as compared with those undergoing non-abdominal procedures [2]
Summary
Reflux of gastric content into the oesophagus is a common event in humans and in veterinary patients undergoing general anaesthesia. This condition, defined as gastroesophageal reflux (GER), occurs in 13.3 to 60% of dogs under general anaesthesia [1,2,3,4]. Gastroesophageal reflux is underdiagnosed in veterinary medicine; when occurring in the peri-anaesthetic period, GER is not usually apparent and is not related to vomiting [1,2,3]. The pathophysiologic mechanism causing anaesthesia-related GER is still under debate; several predisposing factors have been correlated with this condition in anaesthetised dogs: the duration of the preoperative fasting time and the type of food administered [1,9], late
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