Does Intravenous Ondansetron Affect the Intestinal Motility Pattern in Healthy Donkeys (Equus asinus)?

Perioperative management protocol for pediatric endoluminal functional lumen imaging probe in esophageal motility disorders

OBJECTIVES

Lower esophageal sphincter achalasia is associated with a higher risk of aspiration during anesthesia. Endoluminal Functional Lumen Imaging Probe (EndoFLIP) is used as an adjunctive tool in both the diagnosis and treatment of achalasia, for which all children require anesthesia. Anesthesia may affect the parameters of the EndoFLIP due to its effect on gut motility. There are no standard anesthesia protocols to help decrease the risk of aspiration and the undesirable effect of anesthesia on EndoFLIP parameters. This study aims to standardize an anesthesia protocol to target both goals.

METHODS

A protocol was developed to address perioperative management in patients undergoing EndoFLIP for any indication to minimize both anesthetic effect on the esophageal motility as well as perioperative complications. A retrospective data analysis was conducted on patients who underwent EndoFLIP at Cincinnati Children's Hospital Medical Center; pre- and post-protocol implementation data including adverse events was compared.

RESULTS

Pre-protocol implementation: 60 cases (median age of 13.8 years, 30 [50%] females) with 2 cases of adverse events (3.3%). Post-protocol implementation: 71 cases (median age of 14.6 years, 37 [52.1%] females) with no adverse events (0/71 = 0%). In comparison between pre- and post-protocol cases, no significant difference was noted in gender, age, and adverse events. Post-protocol procedures were found to be significantly shorter (median time of 89 vs. 79 min, p = 0.004).

CONCLUSIONS

Our anesthesia protocol provides a standardized way of administering anesthesia minimizing impact on EndoFLIP parameters and aspiration for patients with achalasia.

Evaluation of cardiac indices using M-mode echocardiography after administration of metoclopramide and ondansetron in donkeys (Equus asinus): an experimental study

The aim of the present study was to evaluate cardiac indices using M-mode echocardiography after the administration of metoclopramide and ondansetron in donkeys. For this purpose, 10 apparently healthy Egyptian Baladi donkeys (Equus asinus) were used in a crossover prospective study. Two trials were conducted with the administration of metoclopramide hydrochloride anhydrous at a dose of 0.25 mg Kg-1 and ondansetron hydrochloride sodium at a dose of 0.15 mg Kg-1. The control group (placebo) received a total volume of 50 mL of isotonic saline at 0.9%. An echocardiographic examination was performed using a Digital Color Doppler Ultrasound System equipped with a 2-3.9 MHz phased array sector scanner transducer. In general, the fractional shortening (FS%) was significantly affected by the time for metoclopramide (p = 0.031) and ondansetron (p = 0.047) compared with those of placebo, with treatment with metoclopramide provoking significantly higher percentages of FS% at T60 (p = 0.009) and T90 (p = 0.028) compared with those for ondansetron and placebo. The interaction of time x treatment also showed a statistically significant alteration of FS% (p < 0.05), while the values returned to the basal line at T240. Metoclopramide induced a significant decrease in E-point to septal separation (EPSS) at T90 (p = 0.005), and T240 (p = 0.007) compared with ondansetron and placebo. The time x treatment interaction also showed a significant (p < 0.05) variation in EPSS, with values returning to the basal line at T300. Mitral valve opening velocity (DE SLP) values were significantly affected by time (p = 0.004) in the metoclopramide group compared with those of ondansetron and placebo. Administration of metoclopramide and ondansetron provoked significant alterations of DE SLP at T60 (p = 0.039), T120 (p = 0.036), and T300 (p = 0.005) compared with placebo. In conclusion, caution should be exercised when administering both treatments, especially to animals with suspected cardiac problems.

Evaluation of the effect of different sedative doses of dexmedetomidine on the intestinal motility in clinically healthy donkeys (Equus asinus)

AIM

Gastrointestinal effects of different doses of dexmedetomidine in donkeys are still unidentified. The current study aimed to evaluate the impact of different doses of dexmedetomidine on the motility of selected parts of the gastrointestinal tracts in donkeys using transabdominal ultrasonography.

MATERIALS AND METHODS

An experimental crossover study was conducted on 30 healthy donkeys of both sexes (15 males and 15 females; 160 ± 60 kg). With a two-week washout period, each donkey received an injection of either a normal saline solution or three different doses of dexmedetomidine (3, 5, and 7 μg/kg, respectively). All medications were administered intravenously in equal volumes. The contractility of selected intestinal segments (duodenum, jejunum, left colon, right colon, and cecum) was measured 3 min before administration (zero time) and at 15, 30, 45, 60, 90, and 120 minutes after administration.

RESULTS

Small and large intestinal motility was within the normal ranges before IV injection of normal isotonic saline or dexmedetomidine at a dose of 3, 5, and 7 μg/kg. Two Way Repeated Measures ANOVA output of the data displayed a statistically significant the between time and treatments for the contractility of each of the duodenum (P = 0.0029), jejunum (P = 0.0033), left colon (P = 0.0073), right colon (P = 0.0035), and cecum (P = 0.0026), implying that the impact of treatment on the gastric motility varied among different time points. The simple main effect analysis revealed that the IV dexmedetomidine at 3, 5, and 7 μg/kg doses significantly inhibited (P ≤ 0.01) the bowel contractility compared to the administration of isotonic saline.

CONCLUSION

Dose-dependent inhibitory effect of dexmedetomidine on intestinal motility was reported in donkeys following intravenous administration. This inhibitory effect on intestinal motility should be considered in clinical practice.