Objective

To determine whether suction, lavage and instillation of sodium bicarbonate, following a gastro-oesophageal regurgitation event under general anaesthesia, would alter oesophageal pH to a greater degree than when lavage was not used.

Study design

Prospective, randomised, clinical study.

Animals

A group of 22 client-owned dogs.

Methods

Dogs presenting with gastro-oesophageal regurgitation (GOReg) under general anaesthesia were randomised into groups: no lavage (G1) or lavage (G2). All dogs underwent oesophageal suctioning until no further regurgitant material was retrieved. Dogs in G2 had oesophageal lavage with tap water until the suctioned water was clear. All dogs then had 4.2% sodium bicarbonate (0.6 mL kg^–1) instilled into the oesophagus. An oesophageal pH probe was placed to record pH immediately after: GOReg (T1), suctioning (T2), lavage of the oesophagus (T3; G2 only) and sodium bicarbonate instillation (T4). Categorical data were analysed using Fisher’s exact test, and continuous data were analysed using either the two-sample t-test or the Wilcoxon rank-sum test. Parametric data are reported as mean ± standard deviation and non-parametric data as median (interquartile range). A p value < 0.05 was considered significant.

Results

Oesophageal pH was low in both groups immediately after GOReg [G1: 2.95 (2.20–4.18), G2: 3.29 (1.41–4.03)] but oesophageal pH was not significantly different between groups at T1, T2 and T4. Oesophageal lavage significantly increased pH but the overall change in pH following bicarbonate administration (T2–T4) was not significantly different between groups [G1: 3.16 ± 1.52, G2: 3.52 ± 1.47]. No adverse events following GOReg were recorded.

Conclusions and clinical relevance:

Both groups had similar and clinically important increases in oesophageal pH. Although oesophageal lavage increased pH, this did not affect the final oesophageal pH when sodium bicarbonate was instilled and therefore may be an unnecessary step.

中文翻译：

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全身麻醉期间犬胃食管反流的两种局部治疗方法的比较。

目的

为了确定在全麻情况下胃食管反流事件发生后的抽吸，灌洗和碳酸氢钠滴注是否会比不使用灌洗时更大程度地改变食道pH。

学习规划

前瞻性，随机，临床研究。

动物

一群22只客户拥有的狗。

方法

在全身麻醉下出现胃食管反流（GOReg）的狗被随机分组​​：不灌洗（G1）或灌洗（G2）。所有的狗都接受食道抽吸，直到没有再找到反流材料为止。在G2中的狗用自来水冲洗食道直到吸出的水被清除。然后，所有的狗都将4.2％的碳酸氢钠（0.6 mL kg ^–1）滴入食道。放置食道pH探针以立即记录以下各项的pH：GOReg（T1），抽吸（T2），食道灌洗（T3；仅G2）和碳酸氢钠滴注（T4）。分类数据使用Fisher精确检验进行分析，连续数据使用两样本t进行分析-test或Wilcoxon秩和检验。参数数据报告为均值±标准差，非参数数据报告为中值（四分位间距）。甲p值<0.05被认为显著。

结果

GOReg后即刻，两组的食道pH均较低[G1：2.95（2.20–4.18），G2：3.29（1.41–4.03）]，但两组之间在T1，T2和T4时，食道pH没有显着差异。食道灌洗显着提高了pH，但碳酸氢盐给药后（T2-T4）的pH总体变化在各组之间无显着差异[G1：3.16±1.52，G2：3.52±1.47]。没有记录GOReg后的不良事件。

结论与临床意义：

两组的食管pH值都有相似且临床上重要的升高。尽管食道灌洗液增加了pH值，但当注入碳酸氢钠时，这不会影响最终的食道pH值，因此可能是不必要的步骤。