Tournadre J P, Barclay M, Boulétreau P, Chassard D
Service d'Anesthésie-Réanimation Hôpital de l'Hôtel-Dieu, Lyon, France.
Can J Anaesth. 1998 May;45(5 Pt 1):479-82. doi: 10.1007/BF03012585.
The lower oesophageal sphincter (LOS) is the man mechanism that prevents gastro-oesophageal regurgitation during anaesthesia. The aim of this study was to assess the effect on lower oesophageal sphincter pressure (LOSP) of rapid sequence induction in pigs with full stomachs.
Lower oesophageal sphincter pressure and oesophageal barrier pressure (BrP = LOSP minus gastric pressure) were measured using a water-perfused manometric catheter method in 12 pigs after gastric filling with 500 ml of liquid nutrient mixture. Six pigs were randomly allocated to receive 5 mg.kg-1 propofol and 3 mg.kg-1 succinylcholine i.v. and six pigs received 8 mg.kg-1 thiopentone and 3 mg.kg-1 succinylcholine i.v.
After induction, mean LOSP increased during the period with fasciculations from 19 +/- 4 mmHg to 28 +/- 5 mmHg in the propofol-succinylcholine group and from 23 +/- 6 mmHg to 36 +/- 7 mmHg in the thiopentone-succinylcholine group. The LOSP remained elevated after the fasciculations. LOSP and BrP were not different between the groups.
Induction of anaesthesia with propofol-succinylcholine or thiopentone-succinylcholine increases LOSP and, consequently, BrP in pigs with a full stomach. This increase begins before fasciculations and remains elevated for the period when intubation would occur.
食管下括约肌(LOS)是麻醉期间防止胃食管反流的主要机制。本研究的目的是评估快速顺序诱导对饱胃猪食管下括约肌压力(LOSP)的影响。
采用水灌注测压导管法,对12只胃内注入500ml液体营养混合物的猪测量食管下括约肌压力和食管屏障压(BrP = LOSP减去胃内压)。6只猪随机接受静脉注射5mg·kg-1丙泊酚和3mg·kg-1琥珀酰胆碱,另外6只猪接受静脉注射8mg·kg-1硫喷妥钠和3mg·kg-1琥珀酰胆碱。
诱导后,在肌束颤动期间,丙泊酚-琥珀酰胆碱组的平均LOSP从19±4mmHg升高到28±5mmHg,硫喷妥钠-琥珀酰胆碱组从23±6mmHg升高到36±7mmHg。肌束颤动后LOSP仍保持升高。两组之间的LOSP和BrP没有差异。
用丙泊酚-琥珀酰胆碱或硫喷妥钠-琥珀酰胆碱诱导麻醉可增加饱胃猪的LOSP,从而增加BrP。这种增加在肌束颤动前开始,并在插管期间持续升高。