The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs
Article first published online: 10 APR 2012
Copyright © 2012 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 26, Issue 3, pages 518–525, May-June 2012
How to Cite
Zacuto, A.C., Marks, S.L., Osborn, J., Douthitt, K.L., Hollingshead, K.L., Hayashi, K., Kapatkin, A.S., Pypendop, B.H. and Belafsky, P.C. (2012), The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs. Journal of Veterinary Internal Medicine, 26: 518–525. doi: 10.1111/j.1939-1676.2012.00929.x
- Issue published online: 2 MAY 2012
- Article first published online: 10 APR 2012
- Manuscript Accepted: 10 MAR 2012
- Manuscript Revised: 21 JAN 2012
- Manuscript Received: 1 NOV 2011
- Students Training in Advanced Research (STAR)
Gastroesophageal reflux (GER) is common in anesthetized dogs and can cause esophagitis, esophageal stricture, and aspiration pneumonia.
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.
Sixty-one healthy dogs undergoing elective orthopedic surgery procedures.
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.
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.