Influence of halothane, isoflurane, and sevoflurane on gastroesophageal reflux during anesthesia in dogs

Deborah V. Wilson Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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 BVSc, MS
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Daniel T. Boruta Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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 BS (Zoology), BS (Animal Science)
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A. Tom Evans Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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 DVM, MS

Abstract

Objective—To determine whether maintenance of anesthesia with halothane or sevoflurane is associated with a lower incidence of gastroesophageal reflux (GER) than the use of isoflurane in dogs undergoing orthopedic surgery.

Animals—90 dogs.

Procedures—Dogs were evaluated during elective orthopedic surgery. Dogs with a history of vomiting or that had received any drugs that would alter gastrointestinal tract function were excluded from the study. The anesthetic protocol used was standardized to include administration of acepromazine maleate and morphine prior to induction of anesthesia with thiopental. Dogs were allocated to receive halothane, isoflurane, or sevoflurane to maintain anesthesia. A sensor-tipped catheter was placed to measure esophageal pH during anesthesia. Gastroesophageal reflux was defined as an esophageal pH < 4or > 7.5.

Results—51 dogs had 1 or more episodes of acidic GER during anesthesia. Reflux was detected in 14 dogs receiving isoflurane, 19 dogs receiving halothane, and 18 dogs receiving sevoflurane. In dogs with GER, mean ± SD time from probe placement to onset of GER was 36 ± 65 minutes and esophageal pH remained < 4 for a mean of 64% of the measurement period. There was no significant association between GER and start of surgery or moving a dog on or off the surgery table. Dogs that developed GER soon after induction of anesthesia were more likely to regurgitate.

Conclusions and Clinical Relevance—Maintenance of anesthesia with any of the 3 commonly used inhalant agents is associated with a similar risk for development of GER in dogs.

Abstract

Objective—To determine whether maintenance of anesthesia with halothane or sevoflurane is associated with a lower incidence of gastroesophageal reflux (GER) than the use of isoflurane in dogs undergoing orthopedic surgery.

Animals—90 dogs.

Procedures—Dogs were evaluated during elective orthopedic surgery. Dogs with a history of vomiting or that had received any drugs that would alter gastrointestinal tract function were excluded from the study. The anesthetic protocol used was standardized to include administration of acepromazine maleate and morphine prior to induction of anesthesia with thiopental. Dogs were allocated to receive halothane, isoflurane, or sevoflurane to maintain anesthesia. A sensor-tipped catheter was placed to measure esophageal pH during anesthesia. Gastroesophageal reflux was defined as an esophageal pH < 4or > 7.5.

Results—51 dogs had 1 or more episodes of acidic GER during anesthesia. Reflux was detected in 14 dogs receiving isoflurane, 19 dogs receiving halothane, and 18 dogs receiving sevoflurane. In dogs with GER, mean ± SD time from probe placement to onset of GER was 36 ± 65 minutes and esophageal pH remained < 4 for a mean of 64% of the measurement period. There was no significant association between GER and start of surgery or moving a dog on or off the surgery table. Dogs that developed GER soon after induction of anesthesia were more likely to regurgitate.

Conclusions and Clinical Relevance—Maintenance of anesthesia with any of the 3 commonly used inhalant agents is associated with a similar risk for development of GER in dogs.

Contributor Notes

Supported by a grant from the Companion Animal Fund, Michigan State University.

Presented in part at the 30th Annual Meeting of the American College of Veterinary Anesthesiologists, Athens, Ga, October 2005.

Address correspondence to Dr. Wilson.
  • 1.

    Wilson DV, Evans AT, Miller R. Effects of preanesthetic administration of morphine on gastroesophageal reflux and regurgitation during anesthesia in dogs. Am J Vet Res 2005;66:386390.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Wilson DV, Evans AT, Mauer WA. Influence of metoclopramide on gastroesophageal reflux in anesthetized dogs. Am J Vet Res 2006;67:2631.

  • 3.

    Wilson DV, Walshaw R. Post-anesthetic esophageal dysfunction in 13 dogs. J Am Anim Hosp Assoc 2004;40:455460.

  • 4.

    Galatos AD, Raptopoulos D. Gastro-oesophageal reflux during anaesthesia in the dog: the effects of age, positioning and type of surgical procedure. Vet Rec 1995;137:513516.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Galatos AD, Raptopoulos D. Gastro-esophageal reflux during anaesthesia in the dog: the effect of preoperative fasting and premedication. Vet Rec 1995;137:479483.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Raptopoulos D, Galatos AD. Gastro-oesophageal reflux during anaesthesia induced with either thiopentone or propofol in the dog. J Vet Anaesth 1997;24:2022.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Waterman AE, Hashim MA, Pearson H. Effect of body position on oesophageal and gastric pressures in the anaesthetized dog. J Small Anim Pract 1995;36:196200.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Pratschke KM, Bellenger CR & McAllister H, et al. Barrier pressure at the gastroesophageal junction in anesthetized dogs. Am J Vet Res 2001;62:10681072.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Kohjitani A, Shirakawa J & Satoh E, et al. Effects of sevoflurane and enflurane on lower esophageal sphincter pressure and gastroesophageal pressure gradient in children. J Anesth 1999;13:17.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Sehhati G, Frey R, Star EG. The action of inhalation anesthetics upon the lower oesophageal sphincter. Acta Anaesthesiol Belg 1980;2:9198.

    • Search Google Scholar
    • Export Citation
  • 11.

    Hashim MA, Waterman AE, Pearson H. A comparison of the effects of halothane and isoflurane in combination with nitrous oxide on lower oesophageal sphincter pressure and barrier pressure in anaesthetized dogs. Vet Rec 1995;23:658661.

    • Search Google Scholar
    • Export Citation
  • 12.

    Chassard D, Tournadre JP & Berrada KR, et al. Effect of halothane, isoflurane and desflurane on lower oesophageal sphincter tone. Br J Anaesth 1996;77:781783.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Waterman AE, Hashim MA. Measurement of the length and position of the lower oesophageal sphincter by correlation of external measurements and radiographic estimations in dogs. Vet Rec 1991;129:261264.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Lenth RV. Java applets for power and sample size [computer software]. Available at: www.stat.uiowa.edu/∼rlenth/Power. Accessed May 2, 2005.

    • Search Google Scholar
    • Export Citation
  • 15.

    Carneiro AV. Measures of association in clinical trials: definition and interpretation. Rev Port Cardiol 2003;22:13931401.

  • 16.

    Cook RJ, Sackett DL. The number needed to treat: a clinically useful measure of treatment effect. Br Med J 1995;310:452454.

  • 17.

    Valverde A, Cantwell S & Hernandez J, et al. Effects of acepromazine on the incidence of vomiting associated with opioid administration in dogs. Vet Anaesth Analg 2004;31:4045.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Laitinen S, Mokka REM & Valanne JVI, et al. Anaesthesia induction and lower oesophageal sphincter pressure. Acta Anaesthesiol Scand 1978;22:1620.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Cox MR, Martin CJ & Dent J, et al. Effect of general anesthesia on transient lower oesophageal sphincter relaxations in the dog. Aust N Z J Surg 1988;58:825830.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Evander A, Little AG & Riddell RH, et al. Composition of the refluxed material determines the degree of reflux esophagitis in the dog. Gastroenterology 1987;93:280286.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Stakeberg G, Lehmann A. Influence of different intragastric stimuli on triggering of transient lower oesophageal sphincter relaxation in the dog. Neurogastroenterol Motil 1999;11:125132.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Martin C, Auffray JP & Ragni J, et al. Measurement of lower oesophageal pH during induction of anesthesia, use of oesophageal probe. Acta Anaesthesiol Scand 1992;36:226229.

    • Crossref
    • Search Google Scholar
    • Export Citation

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