Does a metoclopramide CRI reduce the risk of regurgitation associated with BOAS surgery in dogs?

PICO question: In dogs undergoing brachycephalic airway obstruction syndrome (BOAS) surgery does intraoperative constant rate infusion (CRI) of metoclopramide reduce the risk of regurgitation in the perioperative period? Clinical bottom line: Category of research: Treatment. Number and type of study designs reviewed: There were no publications that directly answered the PICO question. Two studies were identified which combined the use of metoclopramide in combination with other measures to reduce perioperative regurgitation. Strength of evidence: Zero. Outcomes reported: There is no data that solely assesses the effect of metoclopramide on gastro-oesophageal reflux in brachycephalic patients undergoing airway surgery. Conclusion: Given the lack of evidence relating to the PICO question, the decision to use metoclopramide is based on personal preference and experience. Other medications and anaesthetic protocols that have been shown to reduce perioperative regurgitation should be considered first. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient's circumstances and owners' values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.