title: Effects of preanesthetic administration of morphine on gastroesophageal reflux and regurgitation during anesthesia in dogs.
abstract: OBJECTIVE
  To determine the effect of morphine administered prior to anesthesia on the incidence of gastroesophageal reflux (GER) in dogs during the subsequent anesthetic episode.
  
  
  METHODS
  90 dogs (30 dogs/group).
  
  
  METHODS
  The randomized prospective clinical study included healthy dogs with no history of vomiting. Dogs were scheduled to undergo elective orthopedic surgery. Food was withheld for (mean+/-SD) 17.8+/-4.1 hours prior to induction of anesthesia. The anesthetic protocol included acepromazine maleate, thiopental, and isoflurane. Dogs were randomly selected to receive morphine at various dosages (0, 0.22, or 1.10 mg/kg, IM) concurrent with acepromazine administration prior to induction of anesthesia. A sensor-tipped catheter was used to measure esophageal pH, and GER was defined as a decrease in pH to < 4 or an increase to > 7.5.
  
  
  RESULTS
  40 dogs had acidic reflux, and 1 had biliary reflux. Proportions of dogs with GER were 8 of 30 (27%), 15 of 30 (50%), and 18 of 30 (60%) for morphine dosages of 0, 0.22, and 1.10 mg/kg, respectively. Mean duration of GER was 91.4+/-56.8 minutes. There was no significant association between GER and age, weight, vomiting after preanesthetic medication, administration of antimicrobials, or start of surgery.
  
  
  CONCLUSIONS
  Most healthy dogs vomit after a large dose of morphine, but vomiting does not increase the likelihood of GER during the subsequent anesthetic episode. Administration of morphine prior to anesthesia substantially increases the incidence of GER during the subsequent anesthetic episode.
authors.affiliation: Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48864, USA.
authors.forename: Deborah V
authors.initials: DV
authors.lastname: Wilson
authors.forename: A Tom
authors.initials: AT
authors.lastname: Evans
authors.forename: RoseAnn
authors.initials: R
authors.lastname: Miller
mesh_terms: D000075:Acepromazine; D000704:Analysis of Variance; D000758:Anesthesia / Q000662:veterinary*; D000818:Animals; D004285:Dogs / Q000378:metabolism* / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D004947:Esophagus / Q000378:metabolism; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000662:veterinary*; D006863:Hydrogen-Ion Concentration; D007530:Isoflurane; D009020:Morphine / Q000627:therapeutic use*; D011229:Preanesthetic Medication / Q000379:methods / Q000662:veterinary*; D011446:Prospective Studies; D014839:Vomiting / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D000075:Acepromazine; D009020:Morphine; D007530:Isoflurane