| Prospective evaluation of adjunctive ketamine on sphincter of Oddi motility in humans. | |
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MedLine Citation:
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PMID: 17593222 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIM: Performance of sphincter of Oddi manometry (SOM) at endoscopic retrograde cholangio-pancreatogram (ERCP) is technically demanding and requires that the patient be well sedated. Droperidol is used as an adjunctive agent in patients who are difficult to sedate. Concerns regarding the safety profile of droperidol and its effects on sphincter of Oddi motility has resulted in the search for other potent sedative agents that do not influence SOM readings. Ketamine, a dissociative anesthetic, is increasingly being used as an adjunctive agent for conscious sedation. This study evaluates the effect of ketamine on sphincter of Oddi motility when used as an adjunctive sedative agent during ERCP. PATIENTS AND METHODS: This is a prospective study of 30 consecutive patients undergoing SOM who were difficult to sedate and required adjunctive ketamine. Manometry was initially performed with intravenous administration of diazepam plus meperidine or a combination of diazepam plus meperidine and midazolam. After the initial two pull-throughs, 20 mg of ketamine was administered intravenously and the measurements were repeated 5 min later. RESULTS: The basal pressures of the biliary sphincter and of the pancreatic sphincter were not significantly altered by ketamine. By using a definition for sphincter of Oddi dysfunction of a basal pressure >or=40 mmHg, concordance (normal vs abnormal) between the basal sphincter pressure before and after ketamine was seen in 28 patients (93%). Ketamine also did not lead to a difference in phasic wave amplitude, duration, or frequency. No complication was associated with ketamine use. CONCLUSIONS: Ketamine at 20 mg did not significantly affect SOM parameters. Further studies are required to confirm our preliminary findings before ketamine can be added to the armamentarium of agents used for performance of sphincter of Oddi manometry. |
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Authors:
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Shyam Varadarajulu; Ashutosh Tamhane; C Mel Wilcox |
Publication Detail:
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Type: Journal Article Date: 2007-06-25 |
Journal Detail:
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Title: Journal of gastroenterology and hepatology Volume: 23 ISSN: 1440-1746 ISO Abbreviation: J. Gastroenterol. Hepatol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-13 Completed Date: 2008-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607909 Medline TA: J Gastroenterol Hepatol Country: Australia |
Other Details:
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Languages: eng Pagination: e405-9 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology-Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA. svaradarajulu@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Gastrointestinal Agents / pharmacology* Humans Ketamine / pharmacology* Male Manometry Middle Aged Prospective Studies Sphincter of Oddi / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Gastrointestinal Agents; 6740-88-1/Ketamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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