title: The influence of esomeprazole and cisapride on gastroesophageal reflux during anesthesia in dogs.
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.
  
  
  METHODS
  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
  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.
authors.affiliation: Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Sacramento, CA 95616, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Zacuto
authors.forename: S L
authors.initials: SL
authors.lastname: Marks
authors.forename: J
authors.initials: J
authors.lastname: Osborn
authors.forename: K L
authors.initials: KL
authors.lastname: Douthitt
authors.forename: K L
authors.initials: KL
authors.lastname: Hollingshead
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: A S
authors.initials: AS
authors.lastname: Kapatkin
authors.forename: B H
authors.initials: BH
authors.lastname: Pypendop
authors.forename: P C
authors.initials: PC
authors.lastname: Belafsky
mesh_terms: D000776:Anesthesiology / Q000379:methods*; D000818:Animals; D020117:Cisapride / Q000627:therapeutic use*; D004283:Dog Diseases / Q000378:metabolism / Q000517:prevention & control*; D004285:Dogs; D017097:Electric Impedance; D064098:Esomeprazole / Q000627:therapeutic use*; D005764:Gastroesophageal Reflux / Q000378:metabolism / Q000517:prevention & control* / Q000662:veterinary*; D006863:Hydrogen-Ion Concentration; D011446:Prospective Studies; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D018709:Statistics, Nonparametric
chemical_list: D017366:Serotonin Receptor Agonists; D064098:Esomeprazole; D020117:Cisapride