Summary
Regurgitation and inhalation of acid gastric content, with resultant chemical pneumonitis, remains a common cause of death during anaesthesia.
The effects of intravenous glycopyrrolate 0.3 mg on the lower oesophageal sphincter tone was studied in normal human subjects. Glycopyrrolate decreased lower oesophageal sphincter pressure by 0.88 kPa (p < 0.005).
This finding is of clinical importance in the pre-operative preparation of patients presenting for emergency surgery. A drug which decreases lower oesophageal sphincter tone would presumably increase the hazard of gastro-oesophageal reflux and pulmonary aspiration of acid gastric content.
Résumé
La régurgitation de liquide gastrique avec bronchoaspiration et pneumonite chimique demeure une cause de mort anesthésique commune. Nous avons étudié, chez des sujets normaux, les effets ďune dose intraveineuse de 0.3 mg de glycopyrrolate sur le sphincter œsophagien inférieur. Cet agent a abaissé de 0.89 kPa (p < 0.005) la pression du sphincter œsophagien inférieur.
Ce résultat est ďimportance clinique dans la prémédication anesthésique des malades opérés en urgence. En effet, un médicament qui abaisse le tonus du sphincter œsophagien inférieur peut présumément augmenter le risque de régurgitation gastrique avec bronchoaspiration.
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Brock-Utne, J.G., Rubin, J., Welman, S. et al. The effect of glycopyrrolate (Robinul) on the lower oesophageal sphincter. Canad. Anaesth. Soc. J. 25, 144–146 (1978). https://doi.org/10.1007/BF03005073
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DOI: https://doi.org/10.1007/BF03005073