Anaesthesia induction and lower oesophageal sphincter pressure. 1978

S Laitinen, and R E Mokka, and J V Valanne, and T K Larmi

The effects of some drugs generally used in premedication for and induction of anaesthesia on the lower oesophageal sphincter (LOS) pressure were investigated in 30 dogs, using the modern oesophageal manometric technique. In thiopental-induced anaesthesia, a distinct pressure gradient was noted between the LOS and gastric pressure. Atropine eliminated this pressure gradient almost completely. Metoclopramide increased the LOS pressure significantly, and subsequent atropine administration was unable to bring it down. Metoclopramide administered after atropine was unable to elevate the LOS pressure reduced by atropine. Succinylcholine had no observable lasting effect on the LOS pressure. The present findings seem to indicate that of the drugs generally used in premedication for and induction of anaesthesia, atropine significantly reduces the LOS competence, thereby creating favourable conditions for gastro-oesophageal reflux (GOR) and consequent postoperative pulmonary complications. Use of metoclopramide in premedication for or induction of anaesthesia to eliminate the depressant effect of atropine on the LOS pressure appears to be indicated.

UI MeSH Term Description Entries
D008297 Male Males
D008787 Metoclopramide A dopamine D2 antagonist that is used as an antiemetic. 4-Amino-5-chloro-N-(2-(diethylamino)ethyl)-2-methoxybenzamide,Cerucal,Maxolon,Metaclopramide,Metoclopramide Dihydrochloride,Metoclopramide Hydrochloride,Metoclopramide Monohydrochloride,Metoclopramide Monohydrochloride, Monohydrate,Primperan,Reglan,Rimetin,Dihydrochloride, Metoclopramide,Hydrochloride, Metoclopramide,Monohydrochloride, Metoclopramide
D011229 Preanesthetic Medication Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic. Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004347 Drug Interactions The action of a drug that may affect the activity, metabolism, or toxicity of another drug. Drug Interaction,Interaction, Drug,Interactions, Drug
D004353 Drug Evaluation, Preclinical Preclinical testing of drugs in experimental animals or in vitro for their biological and toxic effects and potential clinical applications. Drug Screening,Evaluation Studies, Drug, Pre-Clinical,Drug Evaluation Studies, Preclinical,Drug Evaluations, Preclinical,Evaluation Studies, Drug, Preclinical,Evaluation, Preclinical Drug,Evaluations, Preclinical Drug,Medicinal Plants Testing, Preclinical,Preclinical Drug Evaluation,Preclinical Drug Evaluations,Drug Screenings,Screening, Drug,Screenings, Drug
D004943 Esophagogastric Junction The area covering the terminal portion of ESOPHAGUS and the beginning of STOMACH at the cardiac orifice. Gastroesophageal Junction,Gastroesophageal Junctions,Junction, Esophagogastric,Junction, Gastroesophageal,Junctions, Gastroesophageal
D005260 Female Females
D005764 Gastroesophageal Reflux Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER. Esophageal Reflux,Gastro-Esophageal Reflux Disease,GERD,Gastric Acid Reflux,Gastric Acid Reflux Disease,Gastro-Esophageal Reflux,Gastro-oesophageal Reflux,Gastroesophageal Reflux Disease,Reflux, Gastroesophageal,Acid Reflux, Gastric,Gastro Esophageal Reflux,Gastro Esophageal Reflux Disease,Gastro oesophageal Reflux,Gastro-Esophageal Reflux Diseases,Reflux Disease, Gastro-Esophageal,Reflux, Gastric Acid,Reflux, Gastro-Esophageal,Reflux, Gastro-oesophageal

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