Effect of prokinetic agents on ileal contractility in a rabbit model of gastroschisis

Intestinal hypomotility is a major problem after repair of gastroschisis. The authors assessed the effect of four clinically available prokinetic agents on intestinal contractility using a rabbit model of gastroschisis. Gastroschisis was surgically created at 24 days' gestation in fetal rabbits. At term, 10-mm ileal muscle strips were harvested, suspended in an organ bath, and stimulated with 10(-6) mol/L carbechol with and without each prokinetic agent: metoclopromide (1 x 10(-5) mol/L), cisapride (2 x 10(-5) mol/L), erythromycin (1 x 10(-5) mol/L), and octreotide (5 x 10(-5) mol/L). The effect of each agent on contractility was calculated as percent change from maximal response to carbechol alone. There were two control groups: sham operated fetuses, and maternal ileum. Metoclopromide was effective only in the adult rabbits. Cisapride improved contractility in newborns with gastroschisis, as well as in both newborn and adult control groups. Neither erythromycin or octreotide improved bethanechol-induced contractility in any of the animals. These data suggest that cisapride may be useful for treating hypoperistalsis in infants with gastroschisis. Clinical studies must be done to further pursue this finding.