The Effect of Propofol on Human Gastric and Colonic Muscle Contractions

Lee, Tat-Leang; Ang, Sophia Bee Leng; Dambisya, Yoswa M.; Adaikan, Ganesh; Lau, Lang Chu

doi:10.1097/00000539-199911000-00031

Cited by 26 publications

(23 citation statements)

References 15 publications

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“…In vivo at clinically relevant concentrations, propofol impairs gastrointestinal contractile activity [8]. Thus, during the sedation, not only is the child relaxed and nonresistant, but there may also be a pharmacological aid for the pneumatic reduction.…”

Section: Discussionmentioning

confidence: 99%

Deep sedation during pneumatic reduction of intussusception

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Deep sedation during pneumatic reduction of intussusception

et al. 2012

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“…[29][30][31] Additionally, it exhibits an inhibitory effect on spontaneous contractile activity and concentration-dependent depression of Ach-induced contraction on human gastric and colonic smooth muscles, although the mechanism is unknown. 32 Midazolam provides hypnotic, sedative, anxiolytic, amnesic, anticonvulsant, and centrally produced muscle relaxant properties. Fentanyl has a short half-life, potent analgesic effect, and rapid onset of action.…”

Section: Discussionmentioning

confidence: 99%

Propofol-based sedation does not increase rate of perforation during colonoscopic procedur

Amornyotin¹,

Prakanrattana²,

Kachintorn³

et al. 2010

Gastroenterol Insights

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Sedation-related colonoscopic perforation (CP) has been under much debate. Our aim was to assess and compare the CP rate during colonoscopy by using sedation with or without propofol adjuvant. All patients who underwent colonoscopic procedure at the WGO Endoscopy Training Center, Siriraj Hospital, Thailand from March 2005 to October 2007 by using the intravenous sedation (IVS) technique were analyzed. The primary outcome was the CP rate; the secondary outcomes were sedation-related complications and death during and immediately after the procedure. There were 6140 colonoscopies and 1532 flexible sigmoidoscopies during the study period, of which 6122 colonoscopic procedures were performed by using IVS. All of these procedures were categorized into two groups: group A, the IVS technique was propofol-based sedation and group B, the IVS technique was non-propofol-based sedation. After matching the indications of procedure, there were 2022 colonoscopies in group A and 512 colonoscopies in group B. Colonoscopic procedures were performed by staff endoscopists (10.8%) or residents and fellows (89.2%). The characteristics of patients and sedative agents used in perforated patients in both groups were not significantly different. In group A, five patients (0.25%) suffered from perforation and two of them died. In group B, one patient (0.20%) had CP; the difference was not significant (P=0.829). Our data showed that colonoscopy under propofol-based sedation did not increase the perforation rate. Serious complications are uncommon.

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“…Impaired proximal gastric relaxation is associated with altered levels of nitric oxide [1,8] , and has been reported in both patients with diabetes mellitus [1] and critical illness [24] . Whilst increased cytokine production [25] and drug usage [26] can also contribute to impaired relaxation, the impact of these factors are likely to be similar between diabetic and non-DM critically ill patients and probably do not account for the differences in gastric motility seen between the groups.…”

Section: Discussionmentioning

confidence: 99%

Proximal gastric motility in critically ill patients with type 2 diabetes mellitus

Nguyen¹

2007

WJG

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INTRODUCTIONIn the community, approximately 50% of patients with type 1 or 2 diabetes mellitus (DM) have gastroparesis [1] . Although gastric emptying of either a solid or semi-solid meal is consistently slow in these patients, gastric emptying of liquid meals is variable [1][2][3][4] . The aetiology of slow gastric emptying and the variable rate of liquid emptying are unclear, but may be related to hyperglycemia or autonomic neuropathy [1,[5][6][7] , factors that result in motor dysfunction of both the proximal and distal stomach [1,7,8] . Delayed gastric emptying is also common in critically ill patients [9][10][11] and is associated with disturbed motility of both the proximal and distal stomach [10,12,13] . In health, the proximal stomach is a major determinant of liquid gastric emptying and is regulated by feedback from the small intestine. In health, the fundus relaxes in response to the presence of nutrient in the duodenum [14] . Critically ill patients without DM have been reported to have impaired proximal gastric relaxation, reduced fundic wave activity and a failed recovery of proximal gastric volume to prestimulation level [12] . Currently, there are no data on the impact of DM on gastric motor function or emptying during critical illness, despite the fact that one-third of patients admitted to critical care units have DM [15] . Given that both DM and critical illness are risk factors for disturbed gastric motility, we hypothesized that critically ill patients with DM would have abnormal proximal gastric motor activity during fasting and in response to duodenal nutrient infusion, compared to non-diabetic critically ill patients and healthy humans. Abstract AIM: To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with longstanding type 2 diabetes mellitus. MATERIALS AND METHODS Subjects METHODS:Proximal gastric motility was assessed (using a barostat) in 10 critically ill patients with type 2 diabetes mellitus (59 ± 3 years) during two 60-min duodenal infusions of Ensure  (1 and 2 kcal/min), in random order, separated by 2 h fasting. Data were compared with 15 non-diabetic critically ill patients (48 ± 5 years) and 10 healthy volunteers (28 ± 3 years). RESULTS:Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during 1 kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/ min infusion was initially reduced in diabetic patients (P < 0.05) but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic patients. CONCLUSION:In patients with d...

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The Effect of Propofol on Human Gastric and Colonic Muscle Contractions

Cited by 26 publications

References 15 publications

Deep sedation during pneumatic reduction of intussusception

Deep sedation during pneumatic reduction of intussusception

Propofol-based sedation does not increase rate of perforation during colonoscopic procedur

Proximal gastric motility in critically ill patients with type 2 diabetes mellitus

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