Lee T L, Ang S B, Dambisya Y M, Adaikan G P, Lau L C
Department of Anaesthesia, National University of Singapore, Singapore.
Anesth Analg. 1999 Nov;89(5):1246-9.
Although propofol is widely used for sedation in the intensive care unit, there are limited data on its effects on gastrointestinal motility. For that reason, we studied the in vitro effects of propofol on human gastric and colonic smooth muscle. Grossly normal human gastric and colonic muscle strips were mounted in an organ bath set-up for isometric contraction and stimulated by acetylcholine (Ach), using a cumulative dose schedule in the absence or presence of different concentrations of propofol [1.7 x 10(-6) M (0.3 microg/mL) to 4.4 x 10(-4) M (78 microg/mL)]. Ach led to concentration-dependent contraction of both gastric and colonic muscle strips, whereas propofol, at a concentration 6.7 x 10(-6) M (1.2 microg/mL) and above, significantly depressed Ach-induced contraction in a concentration-dependent manner for both smooth muscle preparations. In addition, propofol, at a concentration 2.7 x 10(-5)M (4.8 microg/mL) and above, depressed spontaneous contractile activity of both smooth muscle preparations. Fat emulsion 10% (Intralipid), the solvent for propofol, had no effect on either the spontaneous activity or the Ach-induced contraction of gastric and colonic smooth muscles.
The success of enteral feeding requires a normal gastrointestinal motility. We found that, at clinically relevant concentrations, propofol impaired gastrointestinal contractile activity. Further investigations are required to determine the clinical significance of this change.
尽管丙泊酚在重症监护病房中广泛用于镇静,但关于其对胃肠动力影响的数据有限。因此,我们研究了丙泊酚对人胃和结肠平滑肌的体外作用。将大体正常的人胃和结肠肌条安装在器官浴装置中进行等长收缩,并在不存在或存在不同浓度丙泊酚[1.7×10⁻⁶ M(0.3微克/毫升)至4.4×10⁻⁴ M(78微克/毫升)]的情况下,使用累积剂量方案用乙酰胆碱(Ach)进行刺激。Ach导致胃和结肠肌条的浓度依赖性收缩,而丙泊酚在浓度为6.7×10⁻⁶ M(1.2微克/毫升)及以上时,以浓度依赖性方式显著抑制两种平滑肌制剂中Ach诱导的收缩。此外,丙泊酚在浓度为2.7×10⁻⁵ M(4.8微克/毫升)及以上时,抑制两种平滑肌制剂的自发收缩活性。丙泊酚的溶剂10%脂肪乳剂(英脱利匹特)对胃和结肠平滑肌的自发活性或Ach诱导的收缩均无影响。
肠内营养的成功需要正常的胃肠动力。我们发现,在临床相关浓度下,丙泊酚会损害胃肠收缩活性。需要进一步研究以确定这种变化的临床意义。