The Effect of the Preoperative Fasting Regimen on the Incidence of Gastro-Oesophageal Reflux in 90 Dogs

This study aimed to investigate the effect of three different preoperative fasting regimens on the incidence of gastro-oesophageal reflux (GOR) in dogs under general anaesthesia. Ninety dogs undergoing non-abdominal and non-thoracic elective surgery were included in the study and equally allocated to three groups. Dogs received canned food providing half the daily resting energy requirements (RER) 3 h prior to premedication (group 3H), a quarter of the daily RER 3 h before premedication (group 3Q), and half the daily RER 12 h before premedication (group 12H). The animals were premedicated with acepromazine and pethidine, anaesthesia was induced with propofol and maintained with isoflurane vaporised in oxygen. Oesophageal pH was monitored throughout anaesthesia. Demographic and surgery-related parameters were not different among groups. The incidence of GOR was 11/30 in group 3H (36.7%), 9/30 in group 3Q (30.0%) and 5/30 in group 12H (16.7%), which was not statistically different (p = 0.262). Reduction of the amount of the preoperative meal from half to a quarter of the daily RER did not reduce the incidence of GOR but resulted in a lower oesophageal pH (p = 0.003). The results of this study suggest that the administration of a meal 3 h before anaesthesia does not have any beneficial effect in the reduction of GOR incidence in dogs compared to the administration of a meal 12 h before anaesthesia.

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A Comparative Crossover Study on the Treatment of Heartburn and Epigastric Pain: Liquid Gaviscon and a Magnesium – Aluminium Antacid Gel

Journal of International Medical Research ◽

10.1177/030006058000800411 ◽

1980 ◽

Vol 8 (4) ◽

pp. 300-302 ◽

Cited By ~ 27

Author(s):

B Chevrel

Keyword(s):

Beneficial Effect ◽

Crossover Study ◽

Aluminium Hydroxide ◽

Crossover Trial ◽

Epigastric Pain ◽

Oesophageal Reflux ◽

Antacid Therapy

Forty-four patients with symptoms of gastro-oesophageal reflux were randomly assigned in a crossover trial to treatment for 15-day periods with Liquid Gaviscon (a reflux suppressant) or an antacid gel containing magnesium and aluminium hydroxide. Good relief of symptoms was reported by 84% of patients during therapy with Liquid Gaviscon compared to only 23% during antacid therapy. Relief of symptoms was obtained within 15 minutes by 68% of patients during therapy with Liquid Gaviscon compared to only 9% during antacid treatment. The beneficial effect lasted for more than 4 hours in 75% of patients during treatment with Liquid Gaviscon compared to only 23% of patients obtaining long-term relief during antacid therapy.

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The Contrasting Effects of Enflurane on Transplacental Exchange after Methohexitone and Ketamine Induction of Anaesthesia for Caesarean Section

Anaesthesia and Intensive Care ◽

10.1177/0310057x7800600311 ◽

1978 ◽

Vol 6 (3) ◽

pp. 239-242 ◽

Cited By ~ 1

Author(s):

J. W. Downing ◽

P. J. C. Houlton ◽

J. G. Brock-Utne ◽

R. J. R. Buley

Keyword(s):

Caesarean Section ◽

Beneficial Effect ◽

General Anaesthesia ◽

Elective Caesarean Section ◽

Volatile Agent ◽

Inhalational Agent ◽

Induction Of Anaesthesia ◽

Uterine Relaxation

Supplementation of general anaesthesia with enflurane 0.6% before delivery of the foetus by elective Caesarean section, produced contrasting effects after methohexitone and ketamine administration. Enflurane, an inhalational agent causing vasodilation and uterine relaxation, enhanced maternal to foetal transplacental exchange following methohexitone induction of narcosis. This beneficial effect of the volatile agent was not seen after ketamine, a vasoconstrictor drug which stimulates myometrial contraction.

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Gastro-Oesophageal Reflux and Adverse Respiratory Events in Children under Anaesthesia

Anaesthesia and Intensive Care ◽

10.1177/0310057x9502300510 ◽

1995 ◽

Vol 23 (5) ◽

pp. 587-590 ◽

Cited By ~ 10

Author(s):

J. G. Milross ◽

B. H. Negus ◽

N. E. Street ◽

K. J. Gaskin

Keyword(s):

General Anaesthesia ◽

Ph Monitoring ◽

Acid Reflux ◽

Oesophageal Reflux ◽

Respiratory Events ◽

Respiratory Event ◽

Class 1 ◽

Minor Surgery ◽

Adverse Respiratory Event ◽

Adverse Respiratory Events

The incidence of gastro-oesophageal reflux in children undergoing general anaesthesia has not previously been studied. One-hundred-and-twenty children (ASA Class 1–2) were studied intraoperatively using continuous oesophageal pH monitoring. The incidence of reflux was 2.5% (3 of 120). None of these three patients had an adverse respiratory event. There was no correlation between reflux and adverse respiratory events. Thirteen patients had minor respiratory events without evidence of acid reflux. Gastro-oesophageal reflux does occur in healthy paediatric patients having minor surgery, but was not a significant cause of the adverse respiratory events that occurred in our study.

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Early Post Operative Cognitive Dysfunction (POCD) in middle aged hypertensive patients: A pilot study

Journal of Neuroanaesthesiology and Critical Care ◽

10.4103/2348-0548.139110 ◽

2014 ◽

Vol 01 (03) ◽

pp. 198-203 ◽

Cited By ~ 1

Author(s):

Nidhi Panda ◽

Preethy Mathew ◽

Y. Narayana ◽

Aadarsh Kohli ◽

Komal Gandhi ◽

...

Keyword(s):

Blood Pressure ◽

Pilot Study ◽

General Anaesthesia ◽

Cognitive Dysfunction ◽

Elective Surgery ◽

Pilot Trial ◽

Middle Aged ◽

Hypertensive Patients ◽

Prospective Pilot Study ◽

Hypertensive Group

AbstractBackground: Nowadays, hypertension is prevalent in middle aged persons. Patients with hypertension are known to have cognitive dysfunction and, therefore, may be vulnerable for post-operative cognitive dysfunction (POCD) also. Intra-operative hypotension is documented to be associated with cognitive decline in hypertensive patients. Materials and Methods: A prospective pilot study was conducted in 30 hypertensive (Group H) and 30 non-hypertensive (Group N) patients, aged 40-59 years, undergoing elective surgery under general anaesthesia to estimate the incidence of early POCD in known hypertensive patients and compared with non-hypertensive patients. All patients underwent a “Neuro-psychological Test Battery” to assess cognitive function on preoperative day and on 7th postoperative day. A standard anaesthesia protocol was followed. Vasopressor boluses were used to maintain mean arterial pressure (MAP) within 20% of the baseline value in both groups. Results: The incidence of POCD was 23.3% in hypertensive patients and 20% in non-hypertensive patients. The vasopressor boluses used to maintain blood pressure was more in hypertensive patients (P = 0.041). Consequently, hypertensive patients had a significantly higher minimal MAP (P = 0.001) and a lower fractional minimal MAP (P = 0.011) compared to non-hypertensive patients. No significant correlation was observed between fractional minimal MAP and occurrence of POCD. Conclusion: This pilot trial shows that the incidence of early POCD in middle aged hypertensive and non-hypertensive patients are similar after general anaesthesia.

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Preoperative Fasting among Adult Patients for Elective Surgery in a Kenyan Referral Hospital

International Scholarly Research Notices ◽

10.1155/2017/2159606 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

George Njoroge ◽

Lucy Kivuti-Bitok ◽

Samuel Kimani

Keyword(s):

Elective Surgery ◽

Cross Sectional Study ◽

Adult Patients ◽

Mirror Reflection ◽

Preoperative Fasting ◽

Sectional Study ◽

National Hospital ◽

Cross Sectional ◽

Ethical Approval

Background. Preoperative fasting (POF) is physiologically and precautionary important during anesthesia and surgery. POF from midnight has been practiced despite the recommended shorter practice. Objective. Assessing preoperative fasting among adult patients scheduled for elective surgery at Kenyatta National Hospital (KNH). Methods. A descriptive cross-sectional study involving 65 surgical patients. A questionnaire of mixed questions on demographics, reasons, source of instructions, opinion on instructions, time, premedication practices, outcome, and complains on NPO was used. Analysis was quantitatively done with SPSS v. 22. Ethical approval was obtained from KNH-UoN ERC. Results. Of the respondents 93.8% lacked knowledge on the correct reasons for POF and felt that the instructions were unclear and less important <50%. POF instructions were administered by nurses 80%, anesthetists 15%, and surgeons 5%. Most of respondents (73.8%) fasted > 15 hours. The POF outcomes were rated moderately challenging as follows: prolonged wait for surgery 44.6%, thirst 43.1%, hunger 36.9%, and anxiety 29.2%. Conclusion. Nurses are critical in providing POF instructions and care, and patient knowledge level is a mirror reflection of the quality of interventions. This underscores the need to build capacity for nurses and strengthen the health system to offer individualized preoperative interventions as well as monitoring and clinical auditing of fasting practices.

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Prediction of resting energy requirements in people taking weight-inducing antipsychotic medications

Nutrition & Dietetics ◽

10.1111/j.1747-0080.2010.01450.x ◽

2010 ◽

Vol 67 (3) ◽

pp. 166-170 ◽

Cited By ~ 2

Author(s):

Jenny-Kay SHARPE ◽

Terry STEDMAN ◽

Nuala M. BYRNE ◽

Andrew P. HILLS

Keyword(s):

Energy Requirements ◽

Antipsychotic Medications ◽

Resting Energy

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Risk Factors for Cardiovascular Death After Elective Surgery Under General Anaesthesia

Survey of Anesthesiology ◽

10.1097/00132586-199812000-00021 ◽

1998 ◽

Vol 42 (6) ◽

pp. 329

Author(s):

S. J. HOWELL ◽

Y. M. SEAR ◽

D. YEATES ◽

M. GOLDACRE ◽

J. W. SEAR ◽

...

Keyword(s):

Risk Factors ◽

General Anaesthesia ◽

Elective Surgery ◽

Cardiovascular Death

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Preoperative fasting of patients undergoing elective surgery

British Journal of Nursing ◽

10.12968/bjon.1992.1.6.286 ◽

1992 ◽

Vol 1 (6) ◽

pp. 286-287 ◽

Cited By ~ 1

Author(s):

Philip Hung

Keyword(s):

Elective Surgery ◽

Preoperative Fasting

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A “Light Meal” Three Hours Preoperatively Decreases the Incidence of Gastro-Esophageal Reflux in Dogs

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6399 ◽

2016 ◽

Vol 52 (6) ◽

pp. 357-363 ◽

Cited By ~ 7

Author(s):

Ioannis Savvas ◽

Dimitrios Raptopoulos ◽

Timoleon Rallis

Keyword(s):

Clinical Practice ◽

Preoperative Fasting ◽

Esophageal Reflux ◽

Canned Food ◽

Daily Rate ◽

Esophageal Ph ◽

Fasting Time ◽

Daily Dose ◽

Thiopental Sodium ◽

The Difference

ABSTRACT Emerging evidence from veterinary and medical clinical research shows that reducing preoperative fasting time may reduce the incidence of gastro-esophageal reflux (GER) intraoperatively. In order to evaluate the effect of two different preoperative fasting times on the incidence of GER during general anesthesia, 120 dogs were randomly assigned to two groups: administration of canned food 3 h before premedication (group C3, n = 60) and administration of canned food 10 h before premedication (group C10, n = 60). The animals were premedicated with propionyl-promazine. Anesthesia was induced with thiopental sodium and maintained with halothane. A pH electrode was introduced into the esophagus, and the esophageal pH was constantly monitored. Esophageal pH of less than 4 or greater than 7.5 was taken as an indication of GER. Three of the 60 dogs of group C3 and 12 of the 60 dogs of group C10 experienced a GER episode, the difference being statistically significant (P = .025). Feeding the dog 3 h before anesthesia at a half daily rate reduces significantly the incidence of GER during anesthesia, compared to the administration of the same amount and type of food 10 h before anesthesia. The administration of a half daily dose of an ordinary canine diet may be useful in clinical practice.

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