Brock-Utne J G, Dimopoulos G E, Downing J W, Moshal M G
S Afr Med J. 1982 Mar 27;61(13):465-7.
The effects on lower oesophageal sphincter (LOS) tone of sequential intravenous injections of metoclopramide 10 mg/atropine 0,6 mg and atropine 0,6 mg/metoclopramide 10 mg, given randomly on separate occasions to 8 healthy volunteers, were studied. The administration of metoclopramide increased mean LOS pressure by 13,6 cm H2O (P less than 0,001). Subsequent injection of atropine failed to lower LOS pressure significantly, LOS pressure being sustained at a mean of 11,2 cm H2O above basal control levels (P less than 0,01). In contrast, injection of atropine at a later date in the same subjects lowered the average LOS pressure by 10,5 cm H2O (P less than 0,001), and subsequent intravenous injections of metoclopramide restored LOS pressure to basal levels. The results of this study suggest that metoclopramide should be given prior to atropine before induction of general anaesthesia to counteract the deleterious effects of atropine on LOS tone, thereby helping to reduce the chances of regurgitation and pulmonary aspiration of acid gastric contents.
研究了在8名健康志愿者身上随机、分不同时间依次静脉注射10毫克胃复安/0.6毫克阿托品和0.6毫克阿托品/10毫克胃复安对食管下括约肌（LOS）张力的影响。注射胃复安使LOS平均压力升高13.6厘米水柱（P<0.001）。随后注射阿托品未能显著降低LOS压力，LOS压力维持在比基础对照水平平均高11.2厘米水柱（P<0.01）。相反，在同一受试者稍后时间注射阿托品使LOS平均压力降低10.5厘米水柱（P<0.001），随后静脉注射胃复安使LOS压力恢复到基础水平。本研究结果表明，在全身麻醉诱导前应先注射胃复安再注射阿托品，以抵消阿托品对LOS张力的有害影响，从而有助于减少胃酸胃内容物反流和肺误吸的几率。
