Anagnostou Tilemahos L, Savvas Ioannis, Kazakos George M, Ververidis Haralabos N, Psalla Dimitra, Kostakis Charalampos, Skepastianos Petros, Raptopoulos Dimitris
Anaesthesia and Intensive Care Unit, School of Veterinary Medicine, Faculty of Health, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Surgery and Obstetrics Unit, Department of Clinical Sciences, School of Veterinary Medicine, Faculty of Health, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Vet Anaesth Analg. 2015 Sep;42(5):502-11. doi: 10.1111/vaa.12234. Epub 2014 Oct 28.
To investigate the potential association of increased blood progesterone (P4 ) concentrations and/or late pregnancy with the incidence of gastro-oesophageal reflux (GOR), in healthy bitches undergoing ovariohysterectomy under general anaesthesia during anoestrus or dioestrus or during the second half of pregnancy.
Prospective observational study.
Ninety-four healthy, female, dogs, aged 1-8 years presented for elective ovariohysterectomy.
Non-pregnant animals were classified into group A (anoestrus) (n = 35) if blood P4 concentration was sufficiently low or group D (dioestrus) (n = 26) if blood P4 concentration was sufficiently high. All animals in the second half of pregnancy were classified into group P (n = 33). Acepromazine (0.05 mg kg(-1) ) was administered intramuscularly as preanaesthetic medication, and sodium thiopental (10 mg kg(-1) , with additional doses if needed) was administered intravenously (IV) for induction of anaesthesia. After endotracheal intubation, halothane (1.1-1.3% end-tidal concentration) in oxygen was used for maintenance of anaesthesia. Lower oesophageal pH was monitored continuously throughout surgery using a pH-measuring probe. Reflux was considered to have occurred whenever pH values of >7.5 (alkaline reflux) or <4 (acid reflux) were recorded. On completion of surgery, carprofen (4 mg kg(-1) ) was administered IV. Further administration of analgesics post-operatively was dictated by visual analogue scale pain scoring.
Acid GOR was observed in five of 26 dogs in group D, six of 35 group A, and 12 of 33 group P (p = 0.152). The incidence of GOR in group P approached statistical significance and was higher than the incidence in the combined group A + D (one sided p = 0.044, two sided p = 0.077).
In dogs undergoing ovariohysterectomy, GOR during anaesthesia occurs with a high incidence in dogs in the second half of pregnancy compared to non-pregnant animals during anoestrus or dioestrus.
Measures could be taken in such cases to avoid the consequences of potential reflux.
探讨在处于乏情期、发情后期或妊娠后半期接受全身麻醉下卵巢子宫切除术的健康母犬中，血液孕酮（P4）浓度升高和/或妊娠后期与胃食管反流（GOR）发生率之间的潜在关联。
前瞻性观察研究。
94只年龄在1至8岁的健康雌性犬，前来接受择期卵巢子宫切除术。
非妊娠动物若血液P4浓度足够低则分为A组（乏情期）（n = 35），若血液P4浓度足够高则分为D组（发情后期）（n = 26）。所有处于妊娠后半期的动物分为P组（n = 33）。肌肉注射乙酰丙嗪（0.05 mg kg⁻¹）作为麻醉前用药，静脉注射硫喷妥钠（10 mg kg⁻¹，必要时追加剂量）诱导麻醉。气管插管后，使用氧气中的氟烷（呼气末浓度1.1 - 1.3%）维持麻醉。在整个手术过程中，使用pH测量探头持续监测食管下段pH值。当记录到pH值>7.5（碱性反流）或<4（酸性反流）时，即认为发生了反流。手术结束时，静脉注射卡洛芬（4 mg kg⁻¹）。术后根据视觉模拟评分法疼痛评分决定是否进一步给予镇痛药。
D组26只犬中有5只、A组35只犬中有6只、P组33只犬中有12只观察到酸性GOR（p = 0.152）。P组GOR发生率接近统计学意义，且高于A组 + D组合并组的发生率（单侧p = 0.044，双侧p = 0.077）。
在接受卵巢子宫切除术的犬中，与处于乏情期或发情后期的非妊娠动物相比，妊娠后半期的犬在麻醉期间GOR发生率较高。
在此类情况下可采取措施避免潜在反流的后果。
