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Anaesthesia induction and lower oesophageal sphincter pressure
Acta Anaesthesiologica Scandinavica
|January 1, 1978
Summary
Atropine significantly reduces lower esophageal sphincter (LES) pressure, increasing risks of gastroesophageal reflux (GER). Metoclopramide may counteract this effect, potentially preventing complications during anesthesia.
Area of Science:
- Anesthesiology
- Gastroenterology
- Pharmacology
Background:
- Premedication and anesthesia induction drugs can affect lower esophageal sphincter (LES) pressure.
- LES pressure is critical for preventing gastroesophageal reflux (GER).
Purpose of the Study:
- To investigate the effects of common anesthetic premedication and induction drugs on LES pressure in dogs.
- To evaluate the potential of metoclopramide to counteract drug-induced decreases in LES pressure.
Main Methods:
- Esophageal manometry was used in 30 dogs.
- The study assessed the impact of thiopental, atropine, metoclopramide, and succinylcholine on LES pressure.
Main Results:
- Thiopental-induced anesthesia created a pressure gradient between LES and gastric pressure.
- Atropine administration abolished this gradient, significantly reducing LES competence.
- Metoclopramide increased LES pressure, an effect not reversed by atropine.
- Succinylcholine had no lasting effect on LES pressure.
Conclusions:
- Atropine significantly impairs LES competence, promoting GER and potential pulmonary complications.
- Metoclopramide shows promise in maintaining LES pressure when used with atropine during anesthesia.
- Metoclopramide may be indicated to prevent adverse effects of atropine on LES competence.