嗎啡誘導嘔吐與麻醉中犬隻食道酸鹼值之臨床相關性調查

江茹芳

doi:10.6342/NTU.2011.02292

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嗎啡誘導嘔吐與麻醉中犬隻食道酸鹼值之臨床相關性調查

Clinical relevance of morphine-induced emesis and esophageal pH value in dogs during anesthesia

江茹芳 , Masters　　Advisor：葉力森　　

繁體中文 DOI： 10.6342/NTU.2011.02292

犬；嗎啡；嘔吐；胃食道逆流； dog ； morphine ； vomiting ； gastroesophageal reflux

Abstract │ Reference (78) │ Altmetrics

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Objective  To investigate the relevance of morphine-induced emesis and esophageal pH in dogs undergoing non-abdominal surgery.

Animals 	A total of 47 dogs, 6.1 ± 4.4 years old, and weighing 9.9 ± 8.9 kg. There were 31 dogs in the study group, and 16 dogs in the control group.

Methods 	The study included dogs presenting to the National Taiwan University Veterinary Hospital for non-abdominal surgery. The premedication of the study group should included morphine (0.5mg/kg, I.M.). The control group had no morphine and other opioid analgesics in their anesthetic plan. The use of morphine was determined by the anesthetist based on patients’ clinical condition. All dogs were induced with propofol and maintained with isoflurane. Dogs with chronic gastrointestinal diseases or being persistently treated with drugs known to affect gastric motility, acid secretion and the tone of gastroesophageal sphincter were excluded. The pH of the vomitus and esophageal pH were measured with the esophageal pH meter and recorded by anesthetists during the anesthesia.

Result  In the study group, 19 of 31 dogs experienced vomiting after morphine premedication, and 16 of 31 dogs had gastroesophageal reflux during the anesthesia. 10 of 19 dogs with vomiting and 7 of 12 dogs without vomiting had subsequent gastroesophageal reflux. The administration of morphine and incidence of vomiting have no significant relevance with starting esophageal pH. The incidence of gastroesophageal reflux is significantly increased with the premedication of morphine comparing to the control group.

Conclusion  Morphine-induced emesis has no effect on starting esophageal pH suggests the good efficacy of acid clearance of esophagus. Administration of morphine is related to the increased incidence of gastoesophageal reflux. The adverse effect of morphine premedication could be ignored in short term observation.

Reference ( 78 ) 〈TOP〉

2. Wilson DV, Tom Evans A, Mauer WA. Pre-anesthetic meperidine: associated vomiting and gastroesophageal reflux during the subsequent anesthetic in dogs. Vet Anaesth Analg 2007;34:15-22.
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3. Wilson DV, Boruta DT, Evans AT. Influence of halothane, isoflurane, and sevoflurane on gastroesophageal reflux during anesthesia in dogs. Am J Vet Res 2006;67:1821-1825.
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4. 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;66:386-390.
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5. Wilson DV, Evans AT, Mauer WA. Influence of metoclopramide on gastroesophageal reflux in anesthetized dogs. Am J Vet Res 2006;67:26-31.
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6. 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;137:513-516.
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