NO INHIBITION OF GASTROINTESTINAL PROPULSION AFTER PROPOFOL-N2O O-2 OR PROPOFOL/KETAMINE-N2O/O-2 ANESTHESIA - A COMPARISON OF GASTRO-CECAL TRANSIT AFTER ISOFLURANE ANESTHESIA/
E. Freye et al., NO INHIBITION OF GASTROINTESTINAL PROPULSION AFTER PROPOFOL-N2O O-2 OR PROPOFOL/KETAMINE-N2O/O-2 ANESTHESIA - A COMPARISON OF GASTRO-CECAL TRANSIT AFTER ISOFLURANE ANESTHESIA/, Acta anaesthesiologica Scandinavica, 42(6), 1998, pp. 664-669
Background: Gastrointestinal motility may be considerably reduced by a
naesthesia and or surgery resulting in postoperative ileus. Inhibition
of propulsive gut motility is especially marked after an opioid-based
technique. Little, however, is known of the gastrointestinal effects
of the hypnotic propofol when given continuously over a longer period
of time, which is the case in total intravenous anaesthesia (TIVA) and
in intensive care sedation. Mie therefore set out to study the effect
s of a propofol-based nitrous oxide/oxygen anaesthesia (group PO) on g
astro-caecal transit time. The results were compared with a propofol-k
etamine technique (group PK) and an isoflurane-based anaesthesia (grou
p I; each group n=20). Methods: Gastro-caecal transit was determined b
y measurement of endexpiratory hydrogen concentration (ppm). Following
gastral installation of lactulose at the end of the operation, the di
sacchharide was degraded by bacteria in the caecum, resulting in the l
iberation of hydrogen which was expired. A 100% increase in endexpirat
ory hydrogen concentration compared to the preinduction period was con
sidered the end-Feint of gastrocaecal transit. Results: There was no s
ignificant difference with regard to gastro-caecal transit in the thre
e groups of patients. In the propofol group mean gastro-caecal transit
was 119 (+/-50.6 SD) min, in the propofol-ketamine group it was 147 (
+/-57.4 SD) min, and in the isoflurane group transit time was 122 (+/-
48.6 SD) min. Conclusion: The data suggest that propofol, even when gi
ven as a continuous infusion, does not alter gastrointestinal tract mo
tility more than a standard isoflurane anaesthesia. The data may be pa
rticularily relevant to patients who are likely to develop postoperati
ve ileus. They also suggest that in an ICU setting propofol does not a
lter gut motility more than a sedation technique with the analgesic ke
tamine.