Refluxo gastroesofágico em cadelas submetidas à OVE ou OVH por videocirurgia sob diferentes pressões de CO2

Abstract

The objectives of this study were to verify the occurrence of intraoperative gastroesophageal reflux (GER) in female dogs submitted to elective neuterind by videolaparoscopy with different pneumoperitoneum pressures and using or not antiemetic and to determine if there is a technique that reduces the occurrence of this event, that is, if there is any pneumoperitoneum pressure that has less influence on the occurrence of GER, as well as if metoclopramide could contribute as a preventive. Sixty-six female dogs, weighing 12.4 ± 2.2 kg, 2.6 ± 1.9 years, with no history of emesis or concomitant pathologies, were included in this study. The dogs were divided into nine groups (OVE C, OVE 8, OVE 10, OVE 12, OVH C, OVH 8, OVH 10, OVH 12 and OVH 8 Metoclopramide). In OVE C, laparotomy ovariectomy was performed; in groups OVE 8, OVE 10 and OVE 12, videolaparoscopic ovariectomy was performed with 8, 10 and 12mmHg of CO2 pressure respectively; in the OVH C group, laparotomy ovariohysterectomy was performed; in the OVH 8, OVH 10 and OVH 12 groups, two portals video-assisted ovariohysterectomy were performed using respectively 8, 10 and 12mmHg of CO2 pressure; In the OVH 8 Metoclopramide group, video-assisted OVH was performed by two portals with 8mmHg of pneumoperitoneum pressure and using metoclopramide in the anesthetic premedication.Todas as cadelas foram submetidas à esofagoscopia e pHmetria esofágica durante a cirurgia. It was not possible to attribute GER events to the decubitus changes inherent to the laparoscopic sterilization processes. Age and weight did not differ between bitches in all groups. Pneumoperitoneum time did not differ between OVE and OVH. None of the different pressures applied differently influenced the occurrence of GER. The higher the initial esophageal pH of the dogs, the lower the occurrence of GER. In all groups the esophageal pHs decreased throughout the surgical period, but the conventional groups remained with higher and more stable pHs. Regarding metoclopramide, two groups of dogs submitted to video-assisted two portals OVH with 8mmHg of CO2 pressure were compared, one of them received metoclopramide at the dose of 0.5mg.kg-1 i.m. at the time of premedication. In this study, there was a high occurrence of GER in both groups (57.1% in the non-metoclopramide group and 71.4% in the metoclopramide group) without any statistical difference between them. In conclusion, videosurgery achieved in a higher occurrence of GER compared to conventional surgeries, regardless of the pressure used and metoclopramide did not prevent or reduce the occurrence of GER in bitches submitted to video-assisted OVH, being the high occurrence attributed to the surgery technique. In this scenario, it is suggested continuous research for laparoscopic techniques that reduce (or avoid) GER, considering the importance of minimal invasion procedures.