Randomized, blinded, controlled clinical trial to assess gastroesophageal reflux and regurgitation in dogs undergoing general anesthesia after hydromorphone premedication with or without acepromazine or dexmedetomidine

Renata S. Costa From the Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536;

Search for other papers by Renata S. Costa in
Current site
Google Scholar
PubMed
Close
 DVM MPhil
,
Lois A. Wetmore From the Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536;

Search for other papers by Lois A. Wetmore in
Current site
Google Scholar
PubMed
Close
 DVM, SCD
, and
Amy Stein From the From the Office of Research and Sponsors Program, Midwestern University, Glendale, AZ 85308.

Search for other papers by Amy Stein in
Current site
Google Scholar
PubMed
Close
 PhD

Abstract

OBJECTIVE

To investigate whether premedication with hydromorphone alone or combined with acepromazine or dexmedetomidine affects the incidence of gastroesophageal reflux (GER) and regurgitation in dogs undergoing general anesthesia for elective orthopedic surgery.

ANIMALS

39 healthy client-owned dogs undergoing general anesthesia for elective orthopedic surgery between November 2016 and November 2018.

PROCEDURES

For this prospective, randomized, controlled, blinded clinical trial, dogs were randomly assigned to be premedicated with hydromorphone (0.1 mg/kg, IM) alone (group H [control group]) or with either acepromazine (0.05 mg/kg, IM; group AH) or dexmedetomidine (6 μg/kg, IM; group DH) before undergoing general anesthesia induced with propofol and maintained with isoflurane. A pH sensor–tipped probe was used to identify episodes of GER (esophageal pH < 4 or > 7.5 for ≥ 30 seconds). Results for GER, regurgitation, vomiting, propofol dose, and durations of food withholding and anesthesia were compiled and compared across groups.

RESULTS

There were 13 dogs in each group, and no meaningful differences were detected in age, body weight, sex, breed, or durations of anesthesia or food withholding across groups. Overall, 16 of the 39 (41%) dogs developed GER: 9 in group H, 6 in group AH, and 1 in group DH. The incidence of GER was significantly lower for group DH versus group H. Six of the 39 (15%) dogs regurgitated: 4 in group H and 2 in group AH.

CONCLUSIONS AND CLINICAL RELEVANCE

The combined use of dexmedetomidine and hydromorphone as premedication may be a better choice to reduce GER in healthy dogs undergoing orthopedic surgery than would the use of hydromorphone with or without acepromazine. Additional research is warranted. (Am J Vet Res 2021;82:695–700)

Abstract

OBJECTIVE

To investigate whether premedication with hydromorphone alone or combined with acepromazine or dexmedetomidine affects the incidence of gastroesophageal reflux (GER) and regurgitation in dogs undergoing general anesthesia for elective orthopedic surgery.

ANIMALS

39 healthy client-owned dogs undergoing general anesthesia for elective orthopedic surgery between November 2016 and November 2018.

PROCEDURES

For this prospective, randomized, controlled, blinded clinical trial, dogs were randomly assigned to be premedicated with hydromorphone (0.1 mg/kg, IM) alone (group H [control group]) or with either acepromazine (0.05 mg/kg, IM; group AH) or dexmedetomidine (6 μg/kg, IM; group DH) before undergoing general anesthesia induced with propofol and maintained with isoflurane. A pH sensor–tipped probe was used to identify episodes of GER (esophageal pH < 4 or > 7.5 for ≥ 30 seconds). Results for GER, regurgitation, vomiting, propofol dose, and durations of food withholding and anesthesia were compiled and compared across groups.

RESULTS

There were 13 dogs in each group, and no meaningful differences were detected in age, body weight, sex, breed, or durations of anesthesia or food withholding across groups. Overall, 16 of the 39 (41%) dogs developed GER: 9 in group H, 6 in group AH, and 1 in group DH. The incidence of GER was significantly lower for group DH versus group H. Six of the 39 (15%) dogs regurgitated: 4 in group H and 2 in group AH.

CONCLUSIONS AND CLINICAL RELEVANCE

The combined use of dexmedetomidine and hydromorphone as premedication may be a better choice to reduce GER in healthy dogs undergoing orthopedic surgery than would the use of hydromorphone with or without acepromazine. Additional research is warranted. (Am J Vet Res 2021;82:695–700)

All Time Past Year Past 30 Days
Abstract Views 579 0 0
Full Text Views 3043 1495 131
PDF Downloads 1914 533 41
Advertisement