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A comparison of the effect on gastric emptying of propofol or dexmedetomidine in critically ill patients: preliminary study

Published online by Cambridge University Press:  04 April 2006

D. Memiş ,
D. Dökmeci ,
B. Karamanlıoğlu ,
A. Turan  and
M. Türe
D. Memiş
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
D. Dökmeci
Affiliation:
Trakya University, Department of Pharmacology, Edirne, Turkey
B. Karamanlıoğlu
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
A. Turan
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
M. Türe
Affiliation:
Trakya University, Department of Biostatistic, Edirne, Turkey
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Extract

Summary

Background: Propofol and dexmedetomidine are widely used for sedation in the intensive care unit yet there are limited data on its effects on gastric motility. In our preliminary study, we examined whether or not any effect of propofol and dexmedetomidine on gastric emptying is preserved in critically ill patients. Methods: Twenty-four critically ill, enterally fed adult patients each received enteral feeding via a nasogastric tube at 50 mL h−1 throughout the 5-h study period. Either propofol 2 mg kg−1 h−1 (n = 12, Group P) or dexmedetomidine 0.2 μg kg−1 h− (n = 12, Group D) was given intravenously over 5 h. Gastric motility was measured indirectly by analysis of the absorption over time of 1.5 g of paracetamol administered into the stomach at the start of the study period. At the beginning and end of the study, residual gastric volume and pH of residual gastric fluid were measured. Results: Gastric residual volume measured at the end of propofol infusion (19.33 ± 11.33) was found to be higher when compared with the volume measured before infusion (11.33 ± 4.84) and after dexmedetomidine infusion (9.17 ± 4.54). But, there was no difference between groups in gastric emptying time (AUC120 894.53 ± 499.39 vs. 1113.46 ± 598.09 propofol and dexmedetomidine groups, respectively). Conclusion: In our study, gastric residual volume measured at the end of propofol infusion was found to be higher when compared with the volume measured before infusion and after dexmedetomidine infusion. There was no difference between groups in gastric emptying time.

Keywords

GASTRIC EMPTYINGPROPOFOLDEXMEDETOMIDINECRITICAL ILLNESSCRITICAL CARE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 8 , August 2006 , pp. 700 - 704
Copyright
© 2006 European Society of Anaesthesiology

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References

Venn RM, Grounds RM. Comparison between dexmedetomidine and propofol for sedation in the intensive care unit. Br J Anaesth 2001; 87: 684–690.Google Scholar
Riess ML, Graefe UA, Goeters C et al. Sedation assessment in critically ill patients with bispectral index. Eur J Anaesthesiol 2002; 19: 18–22.Google Scholar
Burns AM, Shelly MP, Park GRI. The use of sedative agents in critically ill patients. Drugs 1992; 43: 507–515.Google Scholar
Lee TL, Adaikan PG, Lau LC et al. Effects of propofol on guinea pig respiratory smooth muscles. J Anaesth 1995; 9: 265–270.Google Scholar
Chang KSK, Davis RF. Propofol produces endothelium dependent vasodilation and may act as a calcium channel blocker. Anesth Analg 1993; 76: 24–32.Google Scholar
Lee TL, Adaikan PG, Lau LC et al. Effects of propofol on gravid human uterine muscle. J Anesth 1997; 11: 71–74.Google Scholar
Lee TL, Ang SBL, Dambisya YM et al. The effect of propofol on human gastric and colonic muscle contractions. Anesth Analg 1999; 89: 1246–1249.Google Scholar
Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology 1991; 74: 581–605.Google Scholar
McArthur KF, Anderson DS, Durbin IP et al. Clonidine and lidamodine to inhibit watery diarrhea in a patient with lung cancer. Ann Intern Med 1982; 96: 323–325.Google Scholar
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: 818–829.Google Scholar
Jooste CA, Mustoe J, Collee G. Metoclopramide improves gastric motility in critically ill patients. Intensive Care Med 1999; 25: 464–468.Google Scholar
Clements JA, Heading RC, Nimmo WS, Prescott LF. Kinetics of acetaminophen absorption and gastric emptying in man. Clin Pharmacol Ther 1978; 24: 420–424.Google Scholar
Gianotti L, Alexander JW, Nelson JL et al. Role of early enteral feeding and acute starvation on postburn bacterial translocation and host defense: prospective, randomized trials. Crit Care Med 1994; 22: 265–272.Google Scholar
Frost P, Edwards N, Bihari D. Gastric emptying in the critically ill-the way forward. Intensive Care Med 1997; 23: 243–245.Google Scholar
Heading RC, Nimmo J, Prescott LF, Tothill P. The dependence of paracetamol absorption on the rate of gastric emptying. Br J Pharmacol 1993; 47: 415–421.Google Scholar
Wallerstedt SM, Bodelsson M. Effects of propofol on isolated human omental arteries and veins. Br J Anaesth 1997; 78: 296–300.Google Scholar
McArthur CJ, Gin T, McLaren IM et al. Gastric emptying following brain injury: effects of choice of sedation and intracranial pressure. Intensive Care Med 1995; 21: 573–576.Google Scholar
Herbert MK, Roth-Goldbrunner S, Holzer P, Roewer N. Clonidine and dexmedetomidine potently inhibit peristalsis in the Guinea pig ileum in vitro. Anesthesiology 2002; 97: 1491–1499.Google Scholar
Fargeas M-J, Fioramonti J, Bueno L. Central alpha 2-adrenergic control of the pattern of small intestinal motility. Gastroenterology 1986; 91: 1470–1475.Google Scholar
De Ponti F, Gisaroni C, Cosentino M et al. Adrenergic mechanism in the control of gastrointestinal motility: from basic science to clinical applications. Pharmacol Ther 1996; 69: 59–78.Google Scholar
Furness JB. Types of neurons in the enteric nervous system. J Auton Nerv Sysy 2000; 81: 87–96.Google Scholar
Adam S, Baston S. A study of problems associated with the delivery of enteral feed in critically ill patients in five ICUs in the UK. Intensive Care Med 1997; 23: 261–266.Google Scholar
Tarling MM, Toner CC, Withington PS et al. A model of gastric emptying using paracetamol absorption in intensive care patients. Intensive Care Med 1997; 23: 256–260.Google Scholar