Effects of remifentanil on gastric tone

Abstract

Remifentanil induced changes in gastric tone with both increases and decreases. The effect of remifentanil on gastric tone is probably dependent on the current state of the systems involved.

Codeine delays gastric emptying through inhibition of gastric motility as assessed with a novel diagnostic intragastric balloon catheter

“…11 Overall, it is assumed that opioids inhibit gastric emptying through inhibition of propulsive gastric contractility and stimulation of distal resistance at the antrum and pylorus. [12][13][14][15] Even though it is well-known that opioids decrease gastric emptying, [16][17][18][19] their effect on gastric motility is less clear and contradicting results have been reported. 13,[18][19][20][21][22][23][24] One factor hampering insight is the paucity of robust research tools.…”

“…25 Barostat experiments showed contradictory effects on proximal gastric tone and its impact on gastric emptying. 18,[22][23][24] Studies using Goelen | 5 manometry and wireless motility capsules report both inhibition and stimulation of contractility following opioid administration. 15,20 Even though, these techniques require lumen-occluding contractions, as seen in the esophagus and distal stomach.…”

Endogenously released opioids mediate meal‐induced gastric relaxation via peripheral mu‐opioid receptors

“…The role of opioids in the control of proximal stomach motility is seemingly complex: it has been shown that the centrally acting mu‐opioid receptor agonists morphine and remifentanil both increased and decreased gastric tone depending on the study protocol and centre 8–10 . In a previous barostat study that we performed the used methods were the same as in this study the centrally acting mu‐opioid receptor antagonist naloxone had no effect on basal gastric tone but inhibited meal‐induced gastric accommodation, although the significance of the latter finding was borderline 11 .…”

“…Delta‐, kappa‐ and mu‐opioid receptors are found throughout the enteric and central nervous system and influence gastrointestinal motility and sensation 4–7 . Only a limited number of studies indicate a complex role for opioids in the control of proximal stomach motility: in different barostat studies, opioid receptor agonists morphine and remifentanil have both increased and decreased gastric tone 8–10 whereas the centrally acting mu‐opioid receptor antagonist naloxone inhibited meal‐induced gastric accommodation 11 . Also the role of opioids in the regulation of food intake is complex: in general opioid agonists enhance feeding and opioid antagonists decrease feeding 12, 13 but these effects are dependent for example on the treatment duration and whether normal weight, low weight (anorexia patients) or obese volunteers/patients are selected 5 …”

The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery

“…In a study on gastric motilitiy, Hammas et al demonstrated that propofol itself had no effect on gastric tone but abolished the decrease in gastric tone caused by morphine . Wallden et al also demonstrated that remifentanil infusion in volunteers could lead to both an increase and decrease in gastric tone, indicating a interindividual variability . As these studies focused on gastric motility, we caution to extrapolate these results to small bowel motility.…”