Normal gallbladder ejection fraction after morphine augmentation.
OBJECTIVE
Morphine sulfate causes spasm of the sphincter of Oddi. Conversely, the cholecystagogue sincalide produces relaxation of the sphincter and contraction of the gallbladder. This prospective study evaluated whether sincalide could produce normal gallbladder emptying after low-dose morphine sulfate (0.04 mg/kg).


METHODS
Thirty to 120 minutes (mean, 51 minutes) after morphine sulfate-augmented gallbladder visualization, 25 gallbladder ejection fractions in 24 patients were measured. One patient was studied twice, 2 weeks apart. Gallbladder ejection fractions were calculated after controlled 30-minute infusions of sincalide (0.02 microg/kg).


RESULTS
Fourteen gallbladder ejection fractions were normal (mean, 63%; range, 45% to 80%) and 11 gallbladder ejection fractions were abnormal (mean, 12%; range, 5% to 19%; P < 0.001).


CONCLUSIONS
Normal gallbladder ejection fractions can be obtained as early as 30 minutes after administration of low-dose morphine sulfate. Potential applications of post-morphine sulfate sincalide challenge would include, for example, to support true-negative morphine sulfate-augmented gallbladder visualization in a patient with a high clinically indicated potential of having acute cholecystitis.
Achong
D M
DM
Department of Radiology, New England Medical Center Hospitals and Tufts University School of Medicine, Boston, Massachusetts 02111, USA. dwight.achong@es.nemc.org
Oates
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D000328:Adult; D002764:Cholecystitis / Q000000981:diagnostic imaging; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D016473:Gallbladder Emptying / Q000187:drug effects* / Q000502:physiology; D005765:Gastrointestinal Agents / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000494:pharmacology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012844:Sincalide / Q000494:pharmacology; D013997:Time Factors
D005765:Gastrointestinal Agents; D009020:Morphine; D012844:Sincalide