EFFECTS OF GENERAL ANAESTHESIA WITH HALOTHANE ON ANTRODUODENAL MOTILITY, pH AND GASTRIC EMPTYING RATE IN MAN

Abstract

Antroduodenal motility, pH and gastric emptying rate were measured in 11 patients undergoing orthopaedic or plastic surgery with general anaesthesia. Motility was measured by manometry and gastric emptying rate by the rate of paracetamol absorption. During anaesthesia, gastric emptying was delayed in eight patients. General anaesthesia with halothane reduced the duration of the interdigestive motility complex (P less than 0.01), mainly by a shortening of phase II (P less than 0.01) which correlated with the inhaled concentrations of halothane (P less than 0.01). Anaesthesia impeded the occurrence of antral contractions during phase II (P less than 0.01); the frequency of contractions was unchanged during anaesthesia, but decreased during the recovery period (P less than 0.01). The amplitudes of antral contractions diminished with anaesthesia (P less than 0.01), but increased after operation. The frequency of contractions in the duodenum was unchanged during phase II and reduced during phase III (P less than 0.01). Gastric pH increased during and after operation (P less than 0.01). General anaesthesia with halothane affects gastroduodenal motility especially during phase II, increases gastric pH and delays gastric emptying rate.

The effect of anesthetic technique on early postoperative gastric emptying: comparison of propofol-remifentanil and opioid-free sevoflurane anesthesia

“…There are only a few studies on volatile agents and gastrointestinal motility. Volatile anesthetics have inhibitory effects on gastric motility, but the effect may cease quickly after termination of the agents [3,25].…”

“…With an inhalation technique without opioids, the effect of inhalation agents on gastric motility may cease quickly after discontinuation of the agent [3]. An intravenous technique with an ultra-shortacting opioid, to minimize the negative opioid effect on motility, combined with propofol, which has antiemetic properties, and to some degree, antagonizes the opioid effect on gastric motility [4], may favor motility.…”

Attitudes to oral feeding following Caesarean section

“…For example, opioids, both parenteral and spinal, can inhibit gastric emptying [9], increase nonpropulsive contractility of the small bowel [10] and delay colonic motility [11]. Volatile agents have been shown to delay gastric emptying [12] and depress colonic activity [13], although the effects are small and probably unimportant clinically, and neostigmine increases the frequency and intensity of smooth muscle contraction throughout the gut. However, it is routine practice to administer these agents during anaesthesia for day-case surgery where patients are safely discharged a few hours postoperatively.…”

The influence of opioids on gastric function: experimental and clinical studies

“…Enflurane increased the frequency of MMC during anesthesia, the frequency slowed to a normal rate after anesthesia, and there were no major effects on contractile activity. In humans, enflurane and halothane depress antral motilty and reduce phase II activity (78). To summarize, volatile anesthetics affect gastric motility, but the effect may cease quickly after termination of the agents.…”

“…Propofol in higher doses might inhibit motility (80), and volatile agents inhibit motility with an effect that ceases quickly after termination of the agents (76)(77)(78). Remifentanil and volatile agents might therefore be considered similar regarding the time course of the gastric inhibition, and that might also explain the finding of no difference.…”