The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs

A. C. Zacuto, Stanley L Marks, J. Osborn, K. L. Douthitt, K. L. Hollingshead, K. Hayashi, Amy Kapatkin, Bruno H Pypendop, Peter C Belafsky

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)518-525
Number of pages8
JournalJournal of Veterinary Internal Medicine
Volume26
Issue number3
DOIs
StatePublished - May 2012

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Esomeprazole
Cisapride
gastroesophageal reflux
Gastroesophageal Reflux
anesthesia
Anesthesia
Dogs
dogs
impedance
placebos
Electric Impedance
Placebos
esophageal diseases
Orthopedic Procedures
Aspiration Pneumonia
Esophageal Stenosis
orthopedics
Esophagitis
intravenous injection
anesthetics

Keywords

  • Esophagitis
  • Impedance
  • pH
  • Reflux

ASJC Scopus subject areas

  • veterinary(all)

Cite this

The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs. / Zacuto, A. C.; Marks, Stanley L; Osborn, J.; Douthitt, K. L.; Hollingshead, K. L.; Hayashi, K.; Kapatkin, Amy; Pypendop, Bruno H; Belafsky, Peter C.

In: Journal of Veterinary Internal Medicine, Vol. 26, No. 3, 05.2012, p. 518-525.

Research output: Contribution to journalArticle

Zacuto, A. C. ; Marks, Stanley L ; Osborn, J. ; Douthitt, K. L. ; Hollingshead, K. L. ; Hayashi, K. ; Kapatkin, Amy ; Pypendop, Bruno H ; Belafsky, Peter C. / The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs. In: Journal of Veterinary Internal Medicine. 2012 ; Vol. 26, No. 3. pp. 518-525.
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abstract = "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.",
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AU - Marks, Stanley L

AU - Osborn, J.

AU - Douthitt, K. L.

AU - Hollingshead, K. L.

AU - Hayashi, K.

AU - Kapatkin, Amy

AU - Pypendop, Bruno H

AU - Belafsky, Peter C

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AB - 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.

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