The Action of Commonly Used Antiemetics on the Lower Oesophageal Sphincter

Brock‐Utne, John G.; Rubin, Joseph; Welman, Shaun; Dimopoulos, G.; Moshal, M G; Downing, J. W.

doi:10.1093/bja/50.3.295

Cited by 30 publications

(10 citation statements)

References 5 publications

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“…The effect of atropine premedication in predisposing to gastric reflux in dogs and cats cannot be discounted because all Harvey's cases had been so treated, but in this present series, only one cat and one dog had received the drug. Other premedicant drugs may act similarly in animalsmorphine sulphate, pethidine hydrochloride and diazepam were found to decrease the lower oesophageal pressure zone and increase the possibility of reflux in both monkeys and man (Hall et al, 1975); promezathine and droperidol have also been associated with evidence of increased gastro-oesophageal reflux in man (Brock-Utne et al, 1978).…”

Section: Discussionmentioning

confidence: 99%

Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats

Pearson¹,

Darke²,

Gibbs³

et al. 1978

J of Small Animal Practice

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Section: Discussionmentioning

confidence: 99%

Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats

Pearson¹,

Darke²,

Gibbs³

et al. 1978

J of Small Animal Practice

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“…9,10 For more than three decades, metoclopramide has been used for the treatment of gastrointestinal disorders. [11][12][13][14][15] In addition to acting centrally as a neuroleptic dopamine D2 receptor antagonist, it also acts peripherally to facilitate acetylcholine transmission at selective muscarinic receptors, resulting in an increased gastric and intestinal motility, enhanced gastric emptying, an antiemetic effect, and increased tone of the LES. [11][12][13][14][15] To our knowledge, there have been no studies examining the influence of metoclopramide on cricoid pressure-induced relaxation of the LES.…”

Section: Since Its Description Bymentioning

confidence: 99%

Metoclopramide Does Not Attenuate Cricoid Pressure–induced Relaxation of the Lower Esophageal Sphincter in Awake Volunteers

et al. 2008

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The current investigation demonstrates that cricoid pressure reflexly decreases LES tone and barrier pressure in awake subjects. Although metoclopramide increased LES and barrier pressures, it did not attenuate cricoid pressure-induced relaxation of the LES and barrier pressures and thus seems to have no value in preventing gastroesophageal reflux during cricoid pressure. Metoclopramide may be useful in preventing reflux when there is need to release or discontinue cricoid pressure.

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“…Postoperative emesis continues to pose problems for surgical patients, and some studies report an incidence as high as 60:/, (1). In spite of numerous studies (2)(3)(4)(5)(6)(7)(8)(9), the ideal pharmacological agent for the prevention of postoperative emetic symptoms has yet to be found. Recent studies report, however, that transdermal scopolamine is effective against seasickness (10)(11)(12)(13)(14).…”

mentioning

confidence: 99%

Double–blind comparison of transdermal scopolamine, droperidol and placebo against postoperative nausea and vomiting

Tigerstedt

Salmela

Aromaa

1988

Acta Anaesthesiol Scand

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Since transdermal scopolamine (TS) seems effective against seasickness, we compared its antiemetic effect with intravenous droperidol (DHBP), our routine antidote for postoperative emesis. Ninety-six female patients (ASA I-II) scheduled for short-stay surgery were randomly allocated to three study groups after giving their informed consent. The three groups were as follows: TS adhesive, delivering 140 micrograms initially and 5 micrograms/h thereafter + placebo 0.5 ml i.v. 5 min before the end of surgery; transdermal placebo adhesive preoperatively + DHBP 0.5 ml (1.25 mg) i.v. 5 min before the end of surgery; transdermal placebo + 0.5 ml placebo i.v. as indicated above. Oxycodone i.m. and glycopyrrolate i.v. were given for premedication together with the test adhesive. Anaesthesia was induced with thiopental and maintained with nitrous oxide and oxygen, enflurane, vecuronium and fentanyl. Neostigmine and glycopyrrolate were administered for reversal. In the recovery room no differences in nausea or vomiting were observed between the groups. Sedation was significantly more marked (P less than 0.15-0.0001) after DHBP than after either TS or the given DHBP and 6% of those given the placebo (P less than 0.05). During the following 24 h nausea was reported more by the placebo patients (25) than by those on TS (20) or DHBP (15) (P less than 0.05). However, actual vomiting on the ward did not differ between the groups. Visual disturbances were more frequent after TS (P less than 0.01). We conclude that prophylactic transdermal scopolamine does not diminish postoperative emetic sequelae.

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The Action of Commonly Used Antiemetics on the Lower Oesophageal Sphincter

Cited by 30 publications

References 5 publications

Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats

Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats

Metoclopramide Does Not Attenuate Cricoid Pressure–induced Relaxation of the Lower Esophageal Sphincter in Awake Volunteers

Double–blind comparison of transdermal scopolamine, droperidol and placebo against postoperative nausea and vomiting

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