Open AccessThe Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs
Author(s) -
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.
Publication year - 2012
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2012.00929.x
Subject(s) - esomeprazole , cisapride , medicine , reflux , anesthesia , placebo , esophageal ph monitoring , gastroenterology , aspiration pneumonia , gerd , pneumonia , alternative medicine , disease , pathology
Background Gastroesophageal reflux ( GER ) is common in anesthetized dogs and can cause esophagitis, esophageal stricture, and aspiration pneumonia. Objective To determine whether preanesthetic IV administration of esomeprazole alone or esomeprazole and cisapride increases esophageal pH and decreases the frequency of GER in anesthetized dogs using combined multichannel impedance and pH monitoring. Animals Sixty‐one healthy dogs undergoing elective orthopedic surgery procedures. Methods Prospective, randomized, placebo‐controlled study. Dogs were randomized to receive IV saline (0.9% NaCl ), esomeprazole (1 mg/kg) alone, or a combination of esomeprazole (1 mg/kg) and cisapride (1 mg/kg) 12–18 hours and 1–1.5 hours before anesthetic induction. An esophageal pH /impedance probe was utilized to measure esophageal pH and detect GER . Results Eight of 21 dogs in the placebo group (38.1%), 8 of 22 dogs in the esomeprazole group (36%), and 2 of 18 dogs in the combined esomeprazole and cisapride group (11%) had ≥1 episode of GER on impedance testing during anesthesia ( P < .05). Esomeprazole was associated with a significant increase in gastric and esophageal pH ( P = .001), but the drug did not significantly decrease the frequency of GER ( P = .955). Concurrent administration of cisapride was associated with a significant decrease in the number of reflux events (RE) compared to the placebo and esomeprazole groups ( P < .05). Conclusions and Clinical Relevance Preanesthetic administration of cisapride and esomeprazole decreases the number of RE in anesthetized dogs, but administration of esomeprazole alone was associated with nonacid and weakly acidic reflux in all but 1 dog.