[Effects of different drugs on the sphincter of Oddi motility: study with choledochoscope manometry].
OBJECTIVE
This study assessed the effects of narcotic analgesics, nitrates drugs, somatostatin analogues on human sphincter of Oddi motility and the antagonistic effects of nitrates drugs and anticholinergic agents against morphine measured by choledochoscope manometry.


METHODS
157 patients who had a T tube after cholecystectomy and choledochotomy were assessed by choledochoscope manometry. They were randomly divided into 5 groups. Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of contractions (SOF), duration of contractions (SOD), duodenal pressure (DP), common bile duct pressure (CBDP) were scored and analyzed.


RESULTS
SOBP, SOCA and SOF increased after injection of morphine and Ap-237, CBDP increased after intramuscular administered morphine. No apparent change occurred after intramuscularly administered pethidine. SOBP and SOCA decreased after tramadol. After intravenous administration of stilamin in a dose of 250 microg/h, SOCA increased. After administration stilamin of 500 microg/h dose, SOCA and SOBP declined. After intravenous administration of sandostatin, CBDP increased obviously. BPOS and SOCA decreased significantly after administration of isosorbide dinitrate (ISDN) and glyceryl trinitrate (GTN), SOBP reduced evidently after application of pentaerythritol tetranitrate (PTN). SOBP, SOCA, SOF and CBDP increased evidently after injection of morphine. After associated application of ISDN and GTN, the four indications above decreased. As to associated application with PTN, SOCA and SOF decreased. After associated application of anisodamine or atropine, SOCA, SOBP declined, after injected buscopan, SOCA, SOBP, SOF all declined.


CONCLUSIONS
The regular dose of morphine and Ap-237 shows excitatory effect on the sphincter of Oddi motility. Tramadol shows inhibitory effect on the sphincter of Oddi. The regular dose of pethidine and sandostatin shows no apparent effect on the sphincter of Oddi. Stilamin in low dose shows excitated effect on the sphincter of Oddi. Nitrates drugs show inhibited effects on SO motility. Nitrates drugs and anticholinergic agents can antagonize the excitated effect of morphine.
Wu
Shuo-dong
SD
The No.2 Department of General Surgery, Second Affiliated Hospital of China Medical University, Shenyang 110001, China. wushuodong@hotmail.com
Zhang
Zhen-hai
ZH
Jin
Jun-zhe
JZ
Kong
Jing
J
Wang
Wei
W
Li
Dong-yan
DY
Zhang
Qiang
Q
Li
Yan-jun
YJ
D000328:Adult; D000368:Aged; D001659:Biliary Tract / Q000503:physiopathology; D002763:Cholecystectomy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009020:Morphine / Q000494:pharmacology; D009294:Narcotics / Q000494:pharmacology; D015282:Octreotide / Q000494:pharmacology; D010417:Pentaerythritol Tetranitrate / Q000494:pharmacology; D009803:Sphincter of Oddi / Q000187:drug effects* / Q000503:physiopathology*; D055815:Young Adult
D009294:Narcotics; D010417:Pentaerythritol Tetranitrate; D009020:Morphine; D015282:Octreotide