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

Wilson, Deborah V.; Boruta, D.; Evans, AT

doi:10.2460/ajvr.67.11.1821

Cited by 53 publications

(38 citation statements)

References 21 publications

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“…Gastroesophageal reflux was detected in 13.3% of the anesthetized dogs in the present study, with this incidence being lower than that observed in other studies with percentages varying from 46 to 60% (Wilson et al 2005(Wilson et al , 2006aPanti et al 2009). All these studies have in common the administration of morphine as part of the pre-anesthetic medication; this seems reasonable when one takes into consideration the finding that morphine reduces EGS tone (Hall et al 1975).…”

Section: Discussioncontrasting

confidence: 81%

“…This technique allows to identify reflux episodes not visualized as regurgitation, as well as to determine some anesthetic agents that predispose to reflux (Galatos and Raptopoulos 1995a, b;Raptopoulos and Galatos 1997;Wilson et al 2005Wilson et al , 2006aWilson et al , b, 2007Anagnostou et al 2009;Panti et al 2009). It has also allowed to determine that the incidence of GER episodes varies between 4.8% (Anagnostou et al 2009) and 60% (Wilson et al 2005), being influenced by several factors, such as age, type of surgical procedure (Galatos and Raptopoulos 1995a), duration of pre-operative fasting, and drugs used for pre-anesthetic medication (Galatos and Raptopoulos 1995b), induction (Raptopoulos and Galatos 1997) and maintenance (Hashim et al 1995;Wilson et al 2006a) of anesthesia.…”

Section: Introductionmentioning

confidence: 98%

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Ambulatory esophageal pHmetry in healthy dogs with and without the influence of general anesthesia

et al. 2011

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This research aimed to determine the value of esophageal pH in awake and anesthetized dogs, to evaluate the esophageal pH value in awake dogs, in different body positions, as well as to study the occurrence of gastroesophageal reflux episodes in these positions. Thus, 40 healthy male and female adult dogs with mean body weight of 15.5 ± 4.6 kg were used. Esophageal pHmetry was conducted by inserting a catheter through the oropharynx in 30 dogs (stage 1) anesthetized with acepromazine, propofol and isoflurane, submitted to elective ovariosalpingohysterectomy. In addition, 8-h esophageal pHmetry was carried out transnasally in 10 awake dogs (stage 2), allowed to move and change body positions (lateral and sternal decubitus, and standing position), which were recorded. The mean esophageal pH value was lower (p < 0.01) in the anesthetized dogs (7.3 ± 0.82) than in the awake dogs (8.2 ± 0.3). Only four anesthetized dogs (13.33%) suffered reflux episodes. Reflux was not observed in the awake dogs and no esophageal pH differences were found between the body positions studied. Compared to the alert state, general anesthesia in dogs submitted to the previously mentioned anesthesia protocol causes esophageal pH reduction and predisposes to the occurrence of gastroesophageal reflux episodes. Transnasal pHmetry of 8 h in healthy awake dogs reveals that the esophageal pH value is alkaline and does not vary according to body position. In these animals, decubitus position is not a determining factor for reflux episodes to occur.

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Section: Discussioncontrasting

confidence: 81%

Section: Introductionmentioning

confidence: 98%

Ambulatory esophageal pHmetry in healthy dogs with and without the influence of general anesthesia

et al. 2011

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“…Although the current study used only isoflurane, other volatile agents (e.g., sevoflurane) appear to produce similar PONV in patients [3]. Dogs were reported to regurgitate after exposure to halothane, isoflurane, or sevoflurarane [24]. …”

Section: Discussionmentioning

confidence: 99%

Post-anesthesia vomiting: Impact of isoflurane and morphine on ferrets and musk shrews

Horn

Meyers

Pak

et al. 2012

Physiology & Behavior

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Although partially controlled with antiemetic drugs, postoperative nausea and vomiting (PONV) continues to be a problem for many patients. Clinical research suggests that opioid analgesics and volatile anesthetics are the main triggers of PONV. The aim of this study was to develop an animal model for post-anesthesia vomiting for future studies to further determine mechanisms and preclinical drug efficacy. Ferrets (N=34) were initially used because they have served as a gold standard for emesis research. Ferrets were tested with several doses of morphine, inhaled isoflurane, and a positive control injection of cisplatin (a chemotherapy agent) to induce emesis. Musk shrews (a small animal model; N=36) were also tested for emesis with isoflurane exposure. A control injection of cisplatin produced emesis in ferrets (ip, 129.8±22.0 retches; 13.7±2.3 vomits; mean ± SEM). Morphine produced a dose-response on emesis in ferrets, with maximal responses at 0.9 mg/kg (sc, 29.6±12.6 retches; 1.8±0.9, vomits). Isoflurane exposure (2–4% for 10 min to 6 h exposure) failed to induce vomiting, was not associated with an increased frequency in emesis when combined with a low dose of morphine (0.1 mg/kg, sc), and failed to produced consistent effects on food and water intake. In contrast to ferrets, musk shrews were very sensitive to isoflurane-induced emesis (0.5 to 3%, 10 min exposure; up to 11.8±2.4 emetic episodes). Overall, these results indicate that ferrets will not be useful for delineating mechanisms responsible for isoflurane-induced emesis; however, musk shrews may prove to be a model for vomiting after inhalation of volatile agents.

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“…Recent research indicates that ferrets do not vomit to isoflurane exposure using 2 to 4% inhaled concentrations and 10 min to 6 h of exposure (Horn et al, 2011). Dogs are reported to regurgitate after exposure to halothane, isoflurane, or sevoflurane (Wilson et al, 2006). Musk shrews vomit after exposure to halothane (inhibited by NK 1 and 5-HT 3 receptor antagonists) and isoflurane (Gardner and Perren, 1998; Horn et al, 2011).…”

Section: Stimulimentioning

confidence: 99%

“…Although there is a potential link between enhanced 5-HT 3 signaling and exposure to inhalational anesthetic agents (Machu and Harris, 1994; Parker et al, 1996), this has not been further explored in the context of emetic testing. Finally, dogs have been reported to regurgitate after exposure to halothane, isoflurane, or sevoflurane (Wilson et al, 2006) but were not specifically tested for emetic responses.…”

Section: Future Directionsmentioning

confidence: 99%

Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting

Horn¹,

Wallisch²,

Homanics³

et al. 2014

European Journal of Pharmacology

189

130

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Clinical research shows that postoperative nausea and vomiting (PONV) is caused primarily by the use of inhalational anesthesia and opioid analgesics. PONV is also increased by several risk predictors, including a young age, female sex, lack of smoking, and a history of motion sickness. Genetic studies are beginning to shed light on the variability in patient experiences of PONV by assessing polymorphisms of gene targets known to play roles in emesis (serotonin type 3, 5-HT3; opioid; muscarinic; and dopamine type 2, D2, receptors) and the metabolism of antiemetic drugs (e.g., ondansetron). Significant numbers of clinical trials have produced valuable information on pharmacological targets important for controlling PONV (e.g., 5-HT3 and D2), leading to the current multi-modal approach to inhibit multiple sites in this complex neural system. Despite these significant advances, there is still a lack of fundamental knowledge of the mechanisms that drive the hindbrain central pattern generator (emesis) and forebrain pathways (nausea) that produce PONV, particularly the responses to inhalational anesthesia. This gap in knowledge has limited the development of novel effective therapies of PONV. The current review presents the state of knowledge on the biological mechanisms responsible for PONV, summarizing both preclinical and clinical evidence. Finally, potential ways to advance the research of PONV and more recent developments on the study of postdischarge nausea and vomiting (PDNV) are discussed.

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

Abstract: Maintenance of anesthesia with any of the 3 commonly used inhalant agents is associated with a similar risk for development of GER in dogs.

Cited by 53 publications

References 21 publications

Ambulatory esophageal pHmetry in healthy dogs with and without the influence of general anesthesia

Ambulatory esophageal pHmetry in healthy dogs with and without the influence of general anesthesia

Post-anesthesia vomiting: Impact of isoflurane and morphine on ferrets and musk shrews

Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting

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