| 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: 20032699 Owner: NLM Status: MEDLINE |
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 microg/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; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 112 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-24 Completed Date: 2010-01-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 19-24 Citation Subset: AIM; IM |
Affiliation:
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Department of Outcomes Research, The Cleveland Clinic, Cleveland, OH 44195, USA. alparslanturan@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Cross-Over Studies Dexmedetomidine / pharmacology* Dose-Response Relationship, Drug Double-Blind Method Esophageal Sphincter, Lower / drug effects* Esophagus / physiology* Female Humans Hypnotics and Sedatives / pharmacology* Male Manometry Pressure Propofol / pharmacology* Stomach / physiology* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Hypnotics and Sedatives; 113775-47-6/Dexmedetomidine; 2078-54-8/Propofol |
| Comments/Corrections | |
Comment In:
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Anesthesiology. 2010 Jan;112(1):10-1
[PMID:
20032696
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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