Thörn S E, Wattwil M, Källander A
Department of Anesthesiology, Orebro Medical Center Hospital, Sweden.
Acta Anaesthesiol Scand. 1994 Jan;38(1):57-62. doi: 10.1111/j.1399-6576.1994.tb03838.x.
The effects of a thoracic epidural analgesia with morphine or bupivacaine on gastroduodenal motility during the fasted state and after food intake were evaluated in healthy volunteers. Nine volunteers were studied on two occasions, separated by at least 2 weeks, and were randomly allocated to receive either epidural morphine or epidural bupivacaine at the T6-T7 level on each occasion. Gastroduodenal motility was measured by manometry. Acetaminophen absorption was used as an indirect measure of the rate of gastric emptying and orocecal transit time was determined by use of the hydrogen breath test after ingestion of raffinose. During the control measurements, before the epidural analgesia, there were no differences in gastroduodenal pressure activity between the morphine and bupivacaine groups. Compared to epidural bupivacaine, epidural morphine significantly changed the pressure activity with a higher number of contractions in the duodenum, both during the fasted state and after food intake. Retrograde pressure activity was seen in the duodenum after epidural morphine but not after epidural bupivacaine. There were no significant differences in the pressure activity in the stomach after epidural morphine compared to epidural bupivacaine. Gastric emptying was delayed and orocecal transit time prolonged after epidural morphine. This study in volunteers showed that epidural morphine, compared to epidural bupivacaine, significantly changed the gastroduodenal motility, both during the fasted state and after food intake.
在健康志愿者中评估了吗啡或布比卡因胸段硬膜外镇痛对禁食状态及进食后胃十二指肠运动的影响。9名志愿者分两次接受研究，两次研究间隔至少2周，每次随机分配接受T6 - T7水平的硬膜外吗啡或硬膜外布比卡因。通过测压法测量胃十二指肠运动。对乙酰氨基酚吸收被用作胃排空速率的间接指标，摄入棉子糖后通过氢呼气试验测定口盲肠转运时间。在硬膜外镇痛前的对照测量中，吗啡组和布比卡因组之间的胃十二指肠压力活动无差异。与硬膜外布比卡因相比，硬膜外吗啡在禁食状态及进食后均显著改变压力活动，十二指肠收缩次数更多。硬膜外吗啡后十二指肠出现逆行压力活动，而硬膜外布比卡因后未出现。与硬膜外布比卡因相比，硬膜外吗啡后胃内压力活动无显著差异。硬膜外吗啡后胃排空延迟，口盲肠转运时间延长。这项针对志愿者的研究表明，与硬膜外布比卡因相比，硬膜外吗啡在禁食状态及进食后均显著改变胃十二指肠运动。
