Document Detail


Relationship between motor function of the proximal stomach and transient lower oesophageal sphincter relaxation after morphine.
MedLine Citation:
PMID:  15306575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Morphine reduces the rate of transient lower oesophageal sphincter (LOS) relaxations but its site of action is presently unknown. There are no data available concerning its motor effects on the proximal stomach, an important site for triggering transient LOS relaxations.
AIM: To evaluate the effect of morphine on the rate of transient LOS relaxations and motor function of the proximal stomach.
SUBJECTS AND METHODS: In 19 healthy subjects, concurrent transient LOS relaxations with a sleeve sensor and motor function of the proximal stomach with a bag connected to an electronic barostat were recorded during pressure controlled (n = 9) and volume controlled (n = 10) gastric distensions after intravenous administration of placebo and morphine 100 microg/kg.
RESULTS: During pressure controlled distensions, intrabag volume was markedly decreased by morphine (median 189 ml (interquartile range 101-448) v 404 (265-868) after placebo; p<0.01) as was the rate of transient LOS relaxations (0.5/30 minutes (0.4-2) v 2.5 (2-4); p<0.01). When intrabag volume was kept constant (525 ml (490-600)) (that is, in volume controlled distensions), the rate of transient LOS relaxations was not affected by morphine (2/30 minutes (2-3) v 2.5 (2-3)). Gastric contractions decreased after morphine similarly during pressure controlled and volume controlled distensions (8.5/30 minutes (4-10) v 15.5 (9.5-20.5), p<0.02; and 6.5 (0-24) v 19.5 (12-22), p<0.05).
CONCLUSIONS: The effect of morphine on transient LOS relaxations is dependent on the decrease in volume of the proximal stomach. Our data suggest that pharmacological interventions which decrease fundal volume should result in control of transient LOS relaxation mediated gastro-oesophageal reflux.
Authors:
R Penagini; M Allocca; P Cantù; M Mangano; D Savojardo; S Carmagnola; P A Bianchi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  53     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-12     Completed Date:  2004-10-04     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  1227-31     Citation Subset:  AIM; IM    
Affiliation:
IRCCS Ospedale Maggiore, Pad Granelli, Via F Sforza 35, 20122 Milan, Italy. bobpenna@policlinico.mi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics, Opioid / pharmacology*
Esophagogastric Junction / drug effects*,  physiology
Female
Gastric Emptying / drug effects*,  physiology
Gastroesophageal Reflux / physiopathology
Humans
Male
Manometry
Morphine / pharmacology*
Muscle Relaxation / drug effects*,  physiology
Muscle, Smooth / drug effects,  physiology
Pressure
Receptors, Opioid, mu / physiology
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Receptors, Opioid, mu; 57-27-2/Morphine
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