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

Iirola, Timo; Vilo, Sanna; Aantaa, Riku; Wendelin‐Saarenhovi, Maria; Neuvonen, Pertti J.; Scheinin, Mika; Olkkola, Klaus T.

doi:10.1093/bja/aer004

Cited by 54 publications

(45 citation statements)

References 25 publications

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“…By contrast, DiMaio Knych et al (2011) reported an increase in borborygmi and bowel movements after IV administration of yohimbine. In line with the current results, dexmedetomidine was found to markedly inhibit gastric emptying and oro-caecal transit in healthy human volunteers (Iirola et al 2011). Further, a 2 -antagonists such as yohimbine have been shown to enhance acetylcholine release in humans, thereby increasing colonic tone and inducing colonic contractions (Bharucha et al 1997).…”

Section: Discussionsupporting

confidence: 90%

Clinical effects and pharmacokinetic variables of romifidine and the peripheral α2‐adrenoceptor antagonist MK‐467 in horses

Vries

Pakkanen

Raekallio

et al. 2016

Veterinary Anaesthesia and Analgesia

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Section: Discussionsupporting

confidence: 90%

Clinical effects and pharmacokinetic variables of romifidine and the peripheral α2‐adrenoceptor antagonist MK‐467 in horses

Vries

Pakkanen

Raekallio

et al. 2016

Veterinary Anaesthesia and Analgesia

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“…[13,22] In healthy volunteer, the inhibitory effect of Dex on gastrointestinal function was consistent with that in animals. [23] …”

Section: Discussionmentioning

confidence: 99%

“…On physiological conditions, Dex might inhibit the motility of gastrointestinal by an action on enteric neurons. [22,23] Whereas on pathological conditions, Dex would rather benefit the gastrointestinal function for it attenuates the intestinal injury induced by I/R. [11,12] Either in vitro or in vivo study, Dex offered protective effect against the gastrointestinal I/R injury.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine improves gastrointestinal motility after laparoscopic resection of colorectal cancer

et al. 2016

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Background:To investigate the effects of intraoperative application of dexmedetomidine (Dex) on early gastrointestinal motility after laparoscopic resection of colorectal cancer.Methods:In this prospective, randomized double-blind investigation, 60 patients who underwent laparoscopic resection of colorectal cancer were randomly allocated to receive Dex (DEX group, n = 30) or saline (CON group, n = 30). In the DEX group, Dex was loaded (1 μg/kg) before anesthesia induction and was infused (0.3 μg/kg/h) during surgery. Time to postoperative first flatus (FFL) and first feces (FFE), and time to regular diet were recorded. Serum diamine oxidase (DAO) activity and intestinal fatty acid-binding protein (I-FABP) were detected.Results:Both the time to the FFL (44.41 ± 4.51 hours vs 61.03 ± 5.16 hours, P = 0.02) and the time to the FFE (60.67 ± 4.94 hours vs 82.50 ± 6.88 hours, P = 0.014) were significantly shorter in the DEX group than the CON group. Furthermore, the time to regular diet of the DEX group was shorter than that of the CON group (76.15 ± 4.11 hours vs 91.50 ± 5.70 hours, P = 0.037). Both DAO and I-FABP increased significantly from beginning of surgery to postoperative day 1 in the CON group (2.49 ± 0.41 ng/mL vs 4.48 ± 0.94 ng/mL for DAO, P = 0.028, 1.32 ± 0.09 ng/mL vs 2.17 ± 0.12 ng/mL for I-FABP, P = 0.045, respectively), whereas no significant change was observed in the DEX group. Furthermore, patients in the DEX group had stable hemodynamics and shorter hospital stay than those in the CON group.Conclusion:Dex administration intraoperatively benefits recovery of gastrointestinal motility function after laparoscopic resection of colorectal cancer with stable hemodynamics during surgery though further studies are needed to explore the mechanisms of Dex on gastrointestinal motility.

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“…Alpha 2‐adrenoceptor agonists such as dexmedetomidine are utilized as additive analgesic drugs, sedatives to reduce analgesic and anesthetic requirements, and treatments for perioperative sympathoadrenal stability. However, these agents have been shown to have significant inhibitory effects on gastric, small intestinal, and colonic motility in veterinary and human patients …”

Section: Pathophysiology Of Gidmmentioning

confidence: 99%

Gastrointestinal dysmotility disorders in critically ill dogs and cats

Whitehead

Cortes

Eirmann

2016

J Vet Emergen Crit Care

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Objective -To review the human and veterinary literature regarding gastrointestinal (GI) dysmotility disorders in respect to pathogenesis, patient risk factors, and treatment options in critically ill dogs and cats. Etiology -GI dysmotility is a common sequela of critical illness in people and small animals. The most common GI motility disorders in critically ill people and small animals include esophageal dysmotility, delayed gastric emptying, functional intestinal obstruction (ie, ileus), and colonic motility abnormalities. Medical conditions associated with the highest risk of GI dysmotility include mechanical ventilation, sepsis, shock, trauma, systemic inflammatory response syndrome, and multiple organ failure. The incidence and pathophysiology of GI dysmotility in critically ill small animals is incompletely understood. Diagnosis -A presumptive diagnosis of GI dysmotility is often made in high-risk patient populations following detection of persistent regurgitation, vomiting, lack of tolerance of enteral nutrition, abdominal pain, and constipation. Definitive diagnosis is established via radioscintigraphy; however, this diagnostic tool is not readily available and is difficult to perform on small animals. Other diagnostic modalities that have been evaluated include abdominal ultrasonography, radiographic contrast, and tracer studies. Therapy -Therapy is centered at optimizing GI perfusion, enhancement of GI motility, and early enteral nutrition. Pharmacological interventions are instituted to promote gastric emptying and effective intestinal motility and prevention of complications. Promotility agents, including ranitidine/nizatidine, metoclopramide, erythromycin, and cisapride are the mainstays of therapy in small animals. Prognosis -The development of complications related to GI dysmotility (eg, gastroesophageal reflux and aspiration) have been associated with increased mortality risk. Institution of prophylaxic therapy is recommended in high-risk patients, however, no consensus exists regarding optimal timing of initiating prophylaxic measures, preference of treatment, or duration of therapy. The prognosis for affected small animal patients remains unknown. (J Vet Emerg

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

Abstract: Dexmedetomidine markedly inhibits gastric emptying and gastrointestinal transit in healthy volunteers.

Cited by 54 publications

References 25 publications

Clinical effects and pharmacokinetic variables of romifidine and the peripheral α2‐adrenoceptor antagonist MK‐467 in horses

Clinical effects and pharmacokinetic variables of romifidine and the peripheral α2‐adrenoceptor antagonist MK‐467 in horses

Dexmedetomidine improves gastrointestinal motility after laparoscopic resection of colorectal cancer

Gastrointestinal dysmotility disorders in critically ill dogs and cats

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