Munn J, Tooley M, Bolsin S, Hronek I, Lowson S, Willcox J
University Department of Anaesthesia, Bristol Royal Infirmary.
Br J Anaesth. 1993 Sep;71(3):379-82. doi: 10.1093/bja/71.3.379.
Metoclopramide is a dopamine receptor antagonist and, in large doses, has been shown to reverse the increase in renal blood flow, the diuresis and the natriuresis produced by a low-dose infusion of dopamine. We gave a single i.v. dose of metoclopramide 10 mg to 21 patients on an intensive care unit who were haemodynamically stable and receiving dopamine 3 micrograms kg-1 min-1. Renal vascular resistance index, measured by duplex Doppler ultrasonography, did not change after metoclopramide. Renal function, measured by creatinine and osmolar clearance, natriuresis, kaliuresis and excretion fractions of sodium and potassium did not change after metoclopramide. We conclude that normal doses of metoclopramide (< 0.2 mg kg-1) do not antagonize the renal effects of a low-dose infusion of dopamine in critically ill patients.
甲氧氯普胺是一种多巴胺受体拮抗剂，大剂量使用时已证明可逆转小剂量输注多巴胺所产生的肾血流量增加、利尿和尿钠排泄增加。我们对21名重症监护病房的患者静脉注射了10毫克甲氧氯普胺，这些患者血流动力学稳定，正接受3微克/千克/分钟的多巴胺输注。通过双功多普勒超声测量的肾血管阻力指数在给予甲氧氯普胺后没有变化。通过肌酐和渗透清除率、尿钠排泄、尿钾排泄以及钠和钾的排泄分数来衡量的肾功能在给予甲氧氯普胺后也没有变化。我们得出结论，正常剂量的甲氧氯普胺（<0.2毫克/千克）不会拮抗危重病患者小剂量输注多巴胺的肾脏效应。
