{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:39:14Z","timestamp":1780353554104,"version":"3.54.1"},"reference-count":20,"publisher":"American Veterinary Medical Association (AVMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"s1\">\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To investigate whether premedication with hydromorphone alone or combined with acepromazine or dexmedetomidine affects the incidence of gastroesophageal reflux (GER) and regurgitation in dogs undergoing general anesthesia for elective orthopedic surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s2\">\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>39 healthy client-owned dogs undergoing general anesthesia for elective orthopedic surgery between November 2016 and November 2018.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s3\">\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>For this prospective, randomized, controlled, blinded clinical trial, dogs were randomly assigned to be premedicated with hydromorphone (0.1 mg\/kg, IM) alone (group H [control group]) or with either acepromazine (0.05 mg\/kg, IM; group AH) or dexmedetomidine (6 \u03bcg\/kg, IM; group DH) before undergoing general anesthesia induced with propofol and maintained with isoflurane. A pH sensor\u2013tipped probe was used to identify episodes of GER (esophageal pH &lt; 4 or &gt; 7.5 for \u2265 30 seconds). Results for GER, regurgitation, vomiting, propofol dose, and durations of food withholding and anesthesia were compiled and compared across groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s4\">\n<jats:title>RESULTS<\/jats:title>\n<jats:p>There were 13 dogs in each group, and no meaningful differences were detected in age, body weight, sex, breed, or durations of anesthesia or food withholding across groups. Overall, 16 of the 39 (41%) dogs developed GER: 9 in group H, 6 in group AH, and 1 in group DH. The incidence of GER was significantly lower for group DH versus group H. Six of the 39 (15%) dogs regurgitated: 4 in group H and 2 in group AH.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s5\">\n<jats:title>CONCLUSIONS AND CLINICAL RELEVANCE<\/jats:title>\n<jats:p>The combined use of dexmedetomidine and hydromorphone as premedication may be a better choice to reduce GER in healthy dogs undergoing orthopedic surgery than would the use of hydromorphone with or without acepromazine. Additional research is warranted. (<jats:italic>Am J Vet Res<\/jats:italic> 2021;82:695\u2013700)<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.82.9.695","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T17:36:51Z","timestamp":1629913011000},"page":"695-700","source":"Crossref","is-referenced-by-count":14,"title":["Randomized, blinded, controlled clinical trial to assess gastroesophageal reflux and regurgitation in dogs undergoing general anesthesia after hydromorphone premedication with or without acepromazine or dexmedetomidine"],"prefix":"10.2460","volume":"82","author":[{"given":"Renata S.","family":"Costa","sequence":"first","affiliation":[{"name":"From the Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois A.","family":"Wetmore","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Stein","sequence":"additional","affiliation":[{"name":"From the From the Office of Research and Sponsors Program, Midwestern University, Glendale, AZ 85308."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"J Am Anim Hosp Assoc","doi-asserted-by":"publisher","first-page":"455","DOI":"10.5326\/0400455","article-title":"Postanesthetic esophageal dysfunction in 13 dogs","volume":"40","author":"Wilson DV","year":"2004","unstructured":"Wilson DV, Walshaw R. Postanesthetic esophageal dysfunction in 13 dogs. J Am Anim Hosp Assoc 2004;40:455\u2013460.10.5326\/0400455"},{"key":"ref2","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/vaa.12110","article-title":"Prevalence and risk factors for canine post-anesthetic aspiration pneumonia (1999\u2013 2009): a multicenter study","volume":"41","author":"Ovbey DH","year":"2014","unstructured":"Ovbey DH, Wilson DV, Bednarski RM,  Prevalence and risk factors for canine post-anesthetic aspiration pneumonia (1999\u2013 2009): a multicenter study. Vet Anaesth Analg 2014;41:127\u2013136.10.1111\/vaa.12110"},{"key":"ref3","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1111\/j.1467-2995.2011.00704.x","article-title":"The risk of passive regurgitation during general anaesthesia in a population of referred dogs in the UK","volume":"39","author":"Lamata C","year":"2012","unstructured":"Lamata C, Loughton V, Jones M,  The risk of passive regurgitation during general anaesthesia in a population of referred dogs in the UK. Vet Anaesth Analg 2012;39:266\u2013274.10.1111\/j.1467-2995.2011.00704.x"},{"key":"ref4","series-title":"Open Vet Sc J","doi-asserted-by":"publisher","first-page":"6","DOI":"10.2174\/1874318801307010006","article-title":"Retrospective study of the risk factors and prevalence of regurgitation in dogs undergoing general anaesthesia","volume":"7","author":"Garcia C","year":"2013","unstructured":"De Miguel Garcia C, Pinchbeck GL, Dugdale A,  Retrospective study of the risk factors and prevalence of regurgitation in dogs undergoing general anaesthesia. Open Vet Sc J 2013;7:6\u201311.10.2174\/1874318801307010006"},{"key":"ref5","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"386","DOI":"10.2460\/ajvr.2005.66.386","article-title":"Effects of preanesthetic administration of morphine on gastroesophageal reflux and regurgitation during anesthesia in dogs","volume":"66","author":"Wilson DV","year":"2005","unstructured":"Wilson DV, Evans AT, Miller R. Effects of preanesthetic administration of morphine on gastroesophageal reflux and regurgitation during anesthesia in dogs. Am J Vet Res 2005;66:386\u2013390.10.2460\/ajvr.2005.66.386"},{"key":"ref6","series-title":"Vet Rec","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1136\/vr.137.20.513","article-title":"Gastro-oesophageal reflux during anaesthesia in the dog: the effect of age, positioning and type of surgical procedure","volume":"137","author":"Galatos AD","year":"1995","unstructured":"Galatos AD, Raptopoulos D. Gastro-oesophageal reflux during anaesthesia in the dog: the effect of age, positioning and type of surgical procedure. Vet Rec 1995;137:513\u2013516.10.1136\/vr.137.20.513"},{"key":"ref7","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1046\/j.1467-2995.2000.00008-11.x","article-title":"Incidence of gastro-oesophageal reflux during anaesthesia, following two different fasting times in dogs","volume":"27","author":"Savas I","year":"2000","unstructured":"Savas I, Raptopoulos D. Incidence of gastro-oesophageal reflux during anaesthesia, following two different fasting times in dogs. Vet Anaesth Analg 2000;27:59\u201360.10.1046\/j.1467-2995.2000.00008-11.x"},{"key":"ref8","series-title":"Veterinary anesthesia and analgesia: the fifth edition of Lumb and Jones","first-page":"659","article-title":"Physiology, pathophysiology, and anesthetic management of patients with gastrointestinal and endocrine disease","author":"Adams JG","year":"2015","unstructured":"Adams JG, Figueiredo JP, Graves TK. Physiology, pathophysiology, and anesthetic management of patients with gastrointestinal and endocrine disease. In: Grimm KA, Lamont LA, Tranquilli WJ, , eds. Veterinary anesthesia and analgesia: the fifth edition of Lumb and Jones. Ames, Iowa: John Wiley & Sons Inc, 2015;659."},{"key":"ref9","series-title":"J Am Anim Hosp Assoc","first-page":"180","article-title":"Ulcerative esophagitis and esophageal stricture","volume":"13","author":"Wilson GP","year":"1977","unstructured":"Wilson GP. Ulcerative esophagitis and esophageal stricture. J Am Anim Hosp Assoc 1977;13:180\u2013185."},{"key":"ref10","series-title":"J Small Anim Pract","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1111\/j.1748-5827.1978.tb05532.x","article-title":"Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats","volume":"19","author":"Pearson H","year":"1978","unstructured":"Pearson H, Darke PG, Gibbs C,  Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats. J Small Anim Pract 1978;19:507\u2013519.10.1111\/j.1748-5827.1978.tb05532.x"},{"key":"ref11","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.2460\/javma.233.11.1748","article-title":"Etiology and clinical outcome in dogs with aspiration pneumonia: 88 cases (2004\u20132006)","volume":"233","author":"Kogan DA","year":"2008","unstructured":"Kogan DA, Johnson LR, Sturges BK,  Etiology and clinical outcome in dogs with aspiration pneumonia: 88 cases (2004\u20132006). J Am Vet Med Assoc 2008;233:1748\u20131755.10.2460\/javma.233.11.1748"},{"key":"ref12","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/01.anes.0000365963.97138.54","article-title":"Effects of dexmedetomidine and propofol on lower esophageal sphincter and gastroesophageal pressure gradient in healthy volunteers","volume":"112","author":"Turan A","year":"2010","unstructured":"Turan A, Wo J, Kasuya Y,  Effects of dexmedetomidine and propofol on lower esophageal sphincter and gastroesophageal pressure gradient in healthy volunteers. Anesthesiology 2010;112:19\u201324.10.1097\/01.anes.0000365963.97138.54"},{"key":"ref13","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/j.1467-2995.2004.00128.x","article-title":"Effects of acepromazine on the incidence of vomiting associated with opioid administration in dogs","volume":"31","author":"Valverde A","year":"2004","unstructured":"Valverde A, Cantwell S, Hern\u00e1ndez J,  Effects of acepromazine on the incidence of vomiting associated with opioid administration in dogs. Vet Anaesth Analg 2004;31:40\u201345.10.1111\/j.1467-2995.2004.00128.x"},{"key":"ref14","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.2460\/javma.237.10.1155","article-title":"Effects of acepromazine, hydromorphone, or an acepromazine-hydromor-phone combination on the degree of sedation in clinically normal dogs (Erratum published in J Am Vet Med Assoc 2011;238:182)","volume":"237","author":"Hofmeister EH","year":"2010","unstructured":"Hofmeister EH, Chandler MJ, Read MR. Effects of acepromazine, hydromorphone, or an acepromazine-hydromor-phone combination on the degree of sedation in clinically normal dogs (Erratum published in J Am Vet Med Assoc 2011;238:182). J Am Vet Med Assoc 2010;237:1155\u20131159.10.2460\/javma.237.10.1155"},{"key":"ref15","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.2460\/ajvr.67.11.1821","article-title":"Influence of halothane, isoflurane, and sevoflurane on gastroesophageal reflux during anesthesia in dogs","volume":"67","author":"Wilson DV","year":"2006","unstructured":"Wilson DV, Boruta DT, Evans AT. Influence of halothane, isoflurane, and sevoflurane on gastroesophageal reflux during anesthesia in dogs. Am J Vet Res 2006;67:1821\u20131825.10.2460\/ajvr.67.11.1821"},{"key":"ref16","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"144","DOI":"10.2460\/ajvr.78.2.144","article-title":"Effect of the duration of food withholding prior to anesthesia on gastroesophageal reflux and regurgitation in healthy dogs undergoing elective orthopedic surgery","volume":"78","author":"Viskjer S","year":"2017","unstructured":"Viskjer S, Sj\u00f6str\u00f6m L. Effect of the duration of food withholding prior to anesthesia on gastroesophageal reflux and regurgitation in healthy dogs undergoing elective orthopedic surgery. Am J Vet Res 2017;78:144\u2013150.10.2460\/ajvr.78.2.144"},{"key":"ref17","series-title":"Am J Vet Res","first-page":"963","article-title":"Effects of atropine, acepromazine, meperidine, and xylazine on gastroesophageal sphincter pressure in the dog","volume":"46","author":"Strombeck DR","year":"1985","unstructured":"Strombeck DR, Harrold D. Effects of atropine, acepromazine, meperidine, and xylazine on gastroesophageal sphincter pressure in the dog. Am J Vet Res 1985;46:963\u2013965."},{"key":"ref18","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1467-2995.2006.00295.x","article-title":"Pre-anaesthetic meperi-dine: associated vomiting and gastroesophageal reflux during the subsequent anesthetic in dogs","volume":"34","author":"Wilson DV","year":"2007","unstructured":"Wilson DV, Evans AT, Mauer WA. Pre-anaesthetic meperi-dine: associated vomiting and gastroesophageal reflux during the subsequent anesthetic in dogs. Vet Anaesth Analg 2007;34:15\u201322.10.1111\/j.1467-2995.2006.00295.x"},{"key":"ref19","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1111\/vaa.12120","article-title":"Maropitant prevented vomiting but not gastroesophageal reflux in anesthetized dogs premedicated with acepromazine-hydromorphone","volume":"41","author":"Johnson RA","year":"2014","unstructured":"Johnson RA. Maropitant prevented vomiting but not gastroesophageal reflux in anesthetized dogs premedicated with acepromazine-hydromorphone. Vet Anaesth Analg 2014;41:406\u2013410.10.1111\/vaa.12120"},{"key":"ref20","series-title":"J Vet Anaesth","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/j.1467-2995.1997.tb00263.x","article-title":"Gastro-oesophageal reflux during anaesthesia induced with either thiopentone or propofol in the dog","volume":"24","author":"Raptopoulos D","year":"1997","unstructured":"Raptopoulos D, Galatos AD. Gastro-oesophageal reflux during anaesthesia induced with either thiopentone or propofol in the dog. J Vet Anaesth 1997;24:20\u201322.10.1111\/j.1467-2995.1997.tb00263.x"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/82\/9\/ajvr.82.9.695.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/82\/9\/ajvr.82.9.695.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/82\/9\/ajvr.82.9.695.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T20:57:02Z","timestamp":1696539422000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/82\/9\/ajvr.82.9.695.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":20,"journal-issue":{"issue":"9"},"URL":"https:\/\/doi.org\/10.2460\/ajvr.82.9.695","relation":{},"ISSN":["0002-9645"],"issn-type":[{"value":"0002-9645","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}