Mosaffa Faramarz, Arhami Dolatabadi Ali, Raoufi Masoomeh, Golpour Faezeh, Ghasemi Mahshid, Yazdipoor Mohammad Javad, Memary Elham
Anesthesiology Department, Akhtar Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Emergency Department, Imam Hossein Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2023 Jan 1;11(1):e6. doi: 10.22037/aaem.v11i1.1892. eCollection 2023.
Induction of anesthesia for emergency procedures, without prior gastric preparation and incomplete fasting, is associated with the risk of reflux of stomach contents and aspiration. This study aimed to evaluate the effect of intravenous (IV) metoclopramide administration on gastric emptying in opium users, candidate for procedural sedation and analgesia (PSA).
In the present case-control study, opium-dependent (case) and non-dependent (control) patients in need of PSA were administered with 10 mg IV metoclopramide after undergoing gastric ultrasonography for determination of its area and contents. Then, 30 minutes after the administration of metoclopramide, the area and contents of the stomach were measured again and compared with the measures obtained before the intervention.
135 patients were evaluated in three groups of 45, including the case, control, and placebo groups. The three groups were similar regarding mean age (p = 0.068), sex (p = 0.067), weight (p = 0.596), height (p = 0.671), body mass index (BMI) (p = 0.877), duration of fasting (p = 0.596), and type of gastric contents (p = 0.124). Mean antral cross-sectional area (CSA) of the study participants in the case, control, and placebo groups before the administration of the drug was 8.49 ± 1.40, 8.31 ± 2.56, and 6.56 ± 1.72 cm, respectively. Mean gastric area in the case (p < 0.001) and control (p < 0.001) groups had significantly decreased after the intervention. Mean antral gastric grade of gastric contents in the case (p < 0.001) and control (p < 0.001) groups had significantly decreased after the intervention.
It seems that metoclopramide administration in opium users in need of PSA leads to a significant decrease in mean gastric area and increases gastric emptying.
在未进行预先胃部准备且禁食不充分的情况下，为急诊手术实施麻醉，会伴有胃内容物反流和误吸的风险。本研究旨在评估静脉注射甲氧氯普胺对需要进行程序镇静和镇痛（PSA）的鸦片使用者胃排空的影响。
在本病例对照研究中，需要PSA的鸦片依赖（病例组）和非依赖（对照组）患者在接受胃部超声检查以确定胃面积和内容物后，静脉注射10毫克甲氧氯普胺。然后，在注射甲氧氯普胺30分钟后，再次测量胃的面积和内容物，并与干预前获得的测量值进行比较。
135名患者被分为三组，每组45名，包括病例组、对照组和安慰剂组。三组在平均年龄（p = 0.068）、性别（p = 0.067）、体重（p = 0.596）、身高（p = 0.671）、体重指数（BMI）（p = 0.877）、禁食时间（p = 0.596）和胃内容物类型（p = 0.124）方面相似。在给药前，病例组、对照组和安慰剂组研究参与者的平均胃窦横截面积（CSA）分别为8.49±1.40、8.31±2.56和6.56±1.72平方厘米。干预后，病例组（p < 0.001）和对照组（p < 0.001）的平均胃面积显著减小。干预后，病例组（p < 0.001）和对照组（p < 0.001）的胃窦胃内容物分级平均显著降低。
对于需要PSA的鸦片使用者，注射甲氧氯普胺似乎会导致平均胃面积显著减小，并加快胃排空。
