Schurizek B A
Department of Anaesthesia, Aarhus Kommunehospital.
Dan Med Bull. 1991 Aug;38(4):347-65.
This survey was based on five recently published papers. The aims of the studies were to to investigate the effect of general anaesthesia on antroduodenal motility, gastric pH and gastric emptying. Antroduodenal motility was measured by manometry, gastric pH by a stomach microelectrode and gastric emptying rate using paracetamol absorption as an index. Two studies deal with antroduodenal motility during basal conditions and after administration of paracetamol and diazepam in 11 healthy volunteers. Three studies deal with the effects of 4 different methods of general anaesthesia on antroduodenal motility, gastric pH and gastric emptying rate in 43 patients undergoing orthopedic or plastic surgery not involving the abdomen having four different methods of general anaesthesia. In the healthy volunteers a close connection between antral activity and gastric emptying rate was found. Paracetamol had no effects on gastric pH. The changes in motility (a shortening of phase III and a decline in the incidence of antral phase III activity) were minor and ascribed to diurnal variations and by a possible stimulation of antral activity by the positioning of the manometric tube. It was found that no paracetamol was absorbed in the quiescent phase I, irrespective of its duration, and that the absorption rate of paracetamol correlated with the duration of phase II and the occurrence of antral activity during phases II and III. The effects of premedication with diazepam on antroduodenal motility, gastric pH and gastric emptying rate was investigated in the same healthy volunteers prior to the patient studies. Also in this study a correlation between antral activity and gastric emptying rate was found. Furthermore, it was observed that some volunteers had fast gastric emptying rate, indicated by fast absorption of paracetamol, the first study day and slow the second. It seemed that any intra- or interindividual variation in gastric emptying rate arises from individual variations in antroduodenal motility. Diazepam tended to increase gastric emptying rate by enhancing the amplitudes of antral contractions and the motility index during phase II and pH of the gastric juice increased. Gastroduodenal motility was found to be normal in patients awaiting elective orthopedic or plastic surgery when premedicated with diazepam. pH of the gastric contents was not different from the findings in volunteers after administration of diazepam. All methods of general anaesthesia reduced the duration of the interdigestive motility complex, mainly by a reduction of phase II. General anaesthesia with halothane and enflurane depressed antral motility.(ABSTRACT TRUNCATED AT 400 WORDS)
这项调查基于最近发表的五篇论文。这些研究的目的是调查全身麻醉对十二指肠运动、胃pH值和胃排空的影响。十二指肠运动通过测压法测量，胃pH值通过胃微电极测量，胃排空率以对乙酰氨基酚吸收为指标进行测定。两项研究涉及11名健康志愿者在基础状态下以及服用对乙酰氨基酚和地西泮后的十二指肠运动。三项研究涉及43例接受不涉及腹部的骨科或整形手术且采用四种不同全身麻醉方法的患者，研究这四种不同全身麻醉方法对十二指肠运动、胃pH值和胃排空率的影响。在健康志愿者中，发现胃窦活动与胃排空率之间存在密切联系。对乙酰氨基酚对胃pH值无影响。运动的变化（第三相缩短以及胃窦第三相活动发生率下降）较小，归因于昼夜变化以及测压管放置可能对胃窦活动的刺激。发现在静止的第一相中，无论其持续时间如何，对乙酰氨基酚均未被吸收，且对乙酰氨基酚的吸收速率与第二相的持续时间以及第二相和第三相期间胃窦活动的发生相关。在对患者进行研究之前，在相同的健康志愿者中研究了地西泮预处理对十二指肠运动、胃pH值和胃排空率的影响。在这项研究中也发现胃窦活动与胃排空率之间存在相关性。此外，观察到一些志愿者胃排空率较快，表现为对乙酰氨基酚在第一天吸收快，第二天吸收慢。似乎胃排空率的任何个体内或个体间差异都源于十二指肠运动的个体差异。地西泮倾向于通过增强胃窦收缩幅度和第二相期间的运动指数来提高胃排空率，并且胃液的pH值升高。当用地西泮进行预处理时，发现等待择期骨科或整形手术的患者胃十二指肠运动正常。胃内容物的pH值与服用地西泮后的志愿者的结果无差异。所有全身麻醉方法均缩短了消化间期运动复合波的持续时间，主要是通过缩短第二相。氟烷和恩氟烷全身麻醉抑制胃窦运动。（摘要截取自400字）
