Effects of Subhypnotic Doses of Propofol on Gastric Emptying in Volunteers

Abstract

Subhypnotic doses of propofol known to be antiemetic do not inhibit GE. These results suggest that the antiemetic properties of propofol are not peripheral and that propofol cannot be considered as a prokinetic agent. V(13)CO(2) must be measured instead of calculated to accurately determine GE.

Dexmedetomidine inhibits gastric emptying and oro-caecal transit in healthy volunteers

“…On the basis of previous studies, 9 we calculated that 10 subjects would be required to demonstrate a 30% difference in paracetamol AUC 0 -90 min values between the placebo and dexmedetomidine phases at a level of significance of P¼0.05 and power of 80%. In the study of Memis and colleagues, 9 the mean value for paracetamol AUC 0 -120 min in the control group was 895 min mg litre 21 with a standard deviation of 500 min mg litre 21 . For calculation of the sample size, we assumed that the standard deviation of the difference between the phases would be equal to the mean value of the difference.…”

“…Venous blood samples were collected immediately before administration of paracetamol (baseline) and thereafter at 10, 20, 30, 40, 50, 60, 70, 80 min and 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.5, and 4 h. Plasma paracetamol concentrations were measured using reversed-phase high-performance liquid chromatography. 16 The lower limit of plasma paracetamol quantification was 0.1 mg litre 21 . Gastric emptying was assessed by the rate of paracetamol absorption using the time to peak plasma concentration, the peak plasma concentration, and the area under the plasma concentrationtime curve.…”

“…infusion of 0.7 mg kg 21 h 21 for 190 min. For comparison, subjects were also given 0.10 mg kg 21 of morphine hydrochloride i.v. over 20 min and a placebo infusion in a randomized order.…”

Gastrointestinal motility and prokinetics in the critically ill

“…Specifically, opiate administration in the critically ill is associated with delayed gastric emptying [3] possibly due to fundal relaxation [22], reduced antral contractions [23] and increased phase 3 frequency [24]. A number of other sedative agents also affect gastrointestinal motility [25][26][27][28][29][30][31][32], however neuromuscular blocking agents appear to have no effect [11].…”

Gastric emptying and the organization of antro‐duodenal pressures in the critically ill

“…Gastric emptying is delayed in approximately 50% of critically ill patients [10][11][12][13][14] and, as a result of this, nasogastric administration of nutrient is compromised. Adequate nutrition is important for optimal clinical outcomes, particularly in longer stay intensive care patients and enteral administration of nutrient is generally considered superior to parenteral nutrition.…”