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Prevalence of and risk factors for intraoperative gastroesophageal reflux and postanesthetic vomiting and diarrhea in dogs undergoing general anesthesia
Author(s) -
Torrente Carlos,
Vigueras Isabel,
Manzanilla Edgar G.,
Villaverde Cecilia,
Fresno Laura,
Carvajal Bibiana,
Fiñana Marina,
CostaFarré Cristina
Publication year - 2017
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12613
Subject(s) - medicine , vomiting , acepromazine , anesthesia , odds ratio , univariate analysis , premedication , reflux , confidence interval , anesthetic , atelectasis , surgery , multivariate analysis , heart rate , disease , blood pressure , lung
Objective To determine the prevalence of intraoperative gastroesophageal reflux (GER) and postanesthetic vomiting and diarrhea, and to evaluate risk factors associated with these gastrointestinal disorders (GID) in dogs undergoing general anesthesia. Design Prospective observational study. Setting University teaching hospital. Animals Two hundred thirty‐seven client‐owned dogs undergoing general inhalant anesthesia for diagnostic or surgical purposes. Interventions None Measurements and Main Results Patient, surgical, and anesthetic variables, and postanesthetic treatments administered in the immediate postanesthesia period were evaluated in relation to GID using univariate and multivariate logistic regression analysis ( P < 0.05). Seventy‐nine of the 237 (33.4%) dogs developed GID during the perianesthetic period. The prevalences of GER, vomiting, and diarrhea were 17.3%, 5.5%, and 10.5%, respectively. Intraabdominal surgery ( P = 0.016; odds ratio [OR] 2.82, 95% confidence interval [CI]: 1.21–6.62), changes in body position ( P = 0.003; OR 3.17, 95% CI: 1.47–6.85), and length of anesthesia ( P = 0.052; OR 1.006, 95% CI: 1.000–1.013) were associated with GER. Changes in the ventilation mode during surgery ( P = 0.011; OR 6.54, 95% CI: 1.8–23.8), length of anesthesia ( P = 0.024; OR 1.001, 95% CI: 1.001–1.020), and rescue synthetic colloid support due to hypotension ( P = 0.005; OR 6.9, 95% CI: 1.82–26.3) were positively associated with postanesthetic vomiting. On the contrary, dogs that received acepromazine as premedication were significantly less likely ( P < 0.019; OR 12.3, 95% CI: 1.52–100) to vomit. Finally, length of anesthesia, changes in body position, changes in ventilation mode, or hypoxemia during the procedure tended to increase the risk (univariate model) of diarrhea during the recovery phase. Conclusions GID are common in dogs undergoing general anesthesia. Duration and characteristics of the procedure, anesthetic management, and changes in certain patient variables are significant risk factors for the presence of GID in the perioperative period.