| Effects of Dexmedetomidine and Propofol on Lower Esophageal Sphincter and Gastroesophageal Pressure Gradient in Healthy Volunteers. | |
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MedLine Citation:
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PMID: 19952727 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Many anesthetics reduce lower esophageal sphincter pressure (LESP). Reduced pressure and consequent reduction in the gastroesophageal pressure gradient (GEPG) thus promotes gastroesophageal reflux and may contribute to aspiration pneumonia and associated morbidity. Therefore, the authors compared LESP and GEPG during dexmedetomidine and propofol sedation. METHODS:: Using a randomized, double-blind, crossover design, 11 healthy volunteers were sedated on 2 separate days. Baseline LESP and GEPG were recorded each day. Subsequently, on each day volunteers received three 40-min-long sedative infusions of increasing doses of 0.6, 1.2, and 2.4 ng/ml dexmedetomidine or 1, 2, and 4 mug/ml propofol. LESP and GEPG were recorded during inhalation and expiration at 20 and 40 min after starting each infusion phase, and these measurements were averaged. Results are presented as mean (95% confidence interval). RESULTS:: Two subjects did not return for the dexmedetomidine study day, and the dexmedetomidine results were unusable in another; propofol results in these volunteers were nonetheless retained for analysis. There were no significant differences in LESP and GEPG as a function of drug. However, there was a small but significant 7.4 (-1.6 to -13.2) mmHg (approximately 25%) dose-dependent decrease in LESP over the range of targeted low to high blood levels of each drug. CONCLUSIONS:: Both dexmedetomidine and propofol have similar effects on LESP and GEPG. Although both of the drugs cause some decrease in LESP at high concentrations, it is unlikely that this effect would promote gastroesophageal reflux during sedation. |
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Authors:
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Alparslan Turan; John Wo; Yusuke Kasuya; Raghavendra Govinda; Ozan Akça; Jarrod E Dalton; Daniel I Sessler; Stefan Rauch |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2009-11-30 |
Journal Detail:
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Title: Anesthesiology Volume: - ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-12-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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* Staff Anesthesiologist, ** Professor and Chair, Department of Outcomes Research, # Biostatistician, Departments of Quantitative Health Sciences and Outcomes Research, The Cleveland Clinic. dagger Professor, Department of Gastroenterology, University of Louisville, Louisville, Kentucky. parallel Associate Professor, daggerdagger Assistant Professor, Department of Anesthesiology and Perioperative Medicine, and the Outcomes Research Consortium, Louisville, Kentucky. double dagger Research Fellow, Department of Anesthesiology and Perioperative Medicine, and the Outcomes Research Consortium, University of Louisville, Louisville, Kentucky. Current position: Attending Anesthesiologist, Tokyo Women's Medical University, Tokyo, Japan. section sign Clinical/Research Fellow, Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky. Current position: Fellow in Cardiac Anesthesia, Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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