Gastro-oesophageal reflux during anaesthesia in the kitten: comparison between use of a laryngeal mask airway or an endotracheal tube. 2009

Aikaterini I Sideri, and Apostolos D Galatos, and George M Kazakos, and Pagona G Gouletsou
Clinic of Surgery, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece. ksideri@vet.uth.gr

OBJECTIVE To compare the incidence of gastro-oesophageal reflux (GOR) during anaesthesia in the kitten when using a laryngeal mask airway (LMA) or an endotracheal tube (ET). METHODS Prospective randomized cross-over experimental study. METHODS Forty Domestic Short Hair laboratory cats, 19 females and 21 males, aged 12-15 weeks and weighing 0.57-1.73 kg (mean 1.13 +/- SD 0.26). METHODS Kittens were anaesthetized twice, once using the LMA and once the ET. Following induction of anaesthesia with isoflurane in an anaesthetic chamber and intubation of the trachea with the ET or placement of the LMA, a pH-electrode was introduced into the lower oesophagus. Monitoring of the oesophageal pH was performed for 45 minutes while anaesthesia was maintained with isoflurane. At the end of the experiment, gastric pH was measured. Kittens that had GOR during the experiment were treated with sucralfate, cisapride and ranitidine for 15 days. Results Oesophageal pH was 6.51 +/- 0.76 and gastric pH was 1.54 +/- 0.59. GOR was observed in nine kittens when the ET was used, and in 20 kittens when the LMA was used, the difference being significant (p = 0.013). The refluxate nearly always was acidic, being alkaline in only one kitten. Most of the GOR episodes occurred shortly after induction of anaesthesia and the oesophageal pH remained below 4.0 until the end of the experiment. No regurgitation was observed. CONCLUSIONS The use of the LMA is associated with an increased incidence of GOR during anaesthesia in the kitten, which is not detected by observation. That this may have occurred should be considered if the kitten demonstrates signs of oesophagitis in the postoperative period.

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008297 Male Males
D002371 Cat Diseases Diseases of the domestic cat (Felis catus or F. domesticus). This term does not include diseases of the so-called big cats such as CHEETAHS; LIONS; tigers, cougars, panthers, leopards, and other Felidae for which the heading CARNIVORA is used. Feline Diseases,Cat Disease,Disease, Cat,Disease, Feline,Diseases, Cat,Diseases, Feline,Feline Disease
D002415 Cats The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801) Felis catus,Felis domesticus,Domestic Cats,Felis domestica,Felis sylvestris catus,Cat,Cat, Domestic,Cats, Domestic,Domestic Cat
D005260 Female Females
D005764 Gastroesophageal Reflux Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER. Esophageal Reflux,Gastro-Esophageal Reflux Disease,GERD,Gastric Acid Reflux,Gastric Acid Reflux Disease,Gastro-Esophageal Reflux,Gastro-oesophageal Reflux,Gastroesophageal Reflux Disease,Reflux, Gastroesophageal,Acid Reflux, Gastric,Gastro Esophageal Reflux,Gastro Esophageal Reflux Disease,Gastro oesophageal Reflux,Gastro-Esophageal Reflux Diseases,Reflux Disease, Gastro-Esophageal,Reflux, Gastric Acid,Reflux, Gastro-Esophageal,Reflux, Gastro-oesophageal
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D017214 Laryngeal Masks A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems. Laryngeal Mask Airway,Airway, Laryngeal Mask,Airways, Laryngeal Mask,Laryngeal Mask,Laryngeal Mask Airways,Mask, Laryngeal,Masks, Laryngeal
D018592 Cross-Over Studies Studies comparing two or more treatments or interventions in which the subjects or patients, upon completion of the course of one treatment, are switched to another. In the case of two treatments, A and B, half the subjects are randomly allocated to receive these in the order A, B and half to receive them in the order B, A. A criticism of this design is that effects of the first treatment may carry over into the period when the second is given. (Last, A Dictionary of Epidemiology, 2d ed) Cross-Over Design,Cross-Over Trials,Crossover Design,Crossover Studies,Crossover Trials,Cross Over Design,Cross Over Studies,Cross Over Trials,Cross-Over Designs,Cross-Over Study,Crossover Designs,Crossover Study,Design, Cross-Over,Design, Crossover,Designs, Cross-Over,Designs, Crossover,Studies, Cross-Over,Studies, Crossover,Study, Cross-Over,Study, Crossover,Trial, Cross-Over,Trial, Crossover,Trials, Cross-Over,Trials, Crossover

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