Effects of remifentanil on gastric tone.
OBJECTIVE
Opioids are well known for impairing gastric motility. The mechanism is far from clear and there is wide interindividual variability. The purpose of this study was to evaluate the effect of remifentanil on proximal gastric tone.


METHODS
Healthy volunteers were studied on two occasions and proximal gastric tone was measured by a gastric barostat. On the first occasion (n=8), glucagon 1 mg IV was given as a reference for a maximal relaxation of the stomach. On the second occasion (n=9), remifentanil was given in incremental doses (0.1, 0.2 and 0.3 microg/kg/min) for 15 min each, followed by a washout period of 30 min. Thereafter, remifentanil was readministered, and 10 min later glucagon 1 mg was given. Mean intragastric bag volumes were calculated for each 5-min interval.


RESULTS
Glucagon decreased gastric tone in all subjects. Remifentanil had a marked effect on gastric tone; we found two distinct patterns of reactions with both increases and decreases in gastric tone and, during the remifentanil infusion, glucagon did not affect gastric tone.


CONCLUSIONS
Remifentanil induced changes in gastric tone with both increases and decreases. The effect of remifentanil on gastric tone is probably dependent on the current state of the systems involved.
Walldén
Jakob
J
Department of Anesthesia, Sundsvall Hospital, Sundsvall, and School of Health and Medical Sciences, Orebro University Orebro, Sweden. jakob.wallden@gmail.com
Thörn
Sven-Egron
SE
Lindberg
Greger
G
Wattwil
Magnus
M
D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005215:Fasting; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology; D005934:Glucagon / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010880:Piperidines / Q000494:pharmacology*; D012016:Reference Values; D000077208:Remifentanil; D013270:Stomach / Q000187:drug effects* / Q000502:physiology
D000701:Analgesics, Opioid; D005765:Gastrointestinal Agents; D010880:Piperidines; D005934:Glucagon; D000077208:Remifentanil