ANISODAMINE RESTORES BOWEL CIRCULATION IN BURN SHOCK

In a group of eight brim patients with a mean of 65.3 +/- 17.4 per cen t TBSA burn injury (range 50-90 per cent TBSA), accompanied by a mean of 43.5 +/- 18.9 per cent TBSA full-thickness injury, it was shown tha t the evidence of global hypovolaemia had disappeared at 12 h after th e injury following aggressive fluid resuscitation, while there was sti ll a subnormal pHi of stomach at 48 h. As a prolonged period of inadeq uacy of oxygen delivery to the intestine might result in impairment of the intestinal mucosal barrier function, and then endogenous endotoxa emia might ensue, ii seems to be important to correct intestinal hypox ia as early as possible. Since the inadequate perfusion to the gut wal l is due to selective vasoconstriction? of the mesenteric vasculature, logic dictates that the use of a vasodilator is in order. Anisodamine , an anticholinergic drug, was then given in six burn patients with co mparable burn size and amount of fluid replenishment with the eight pa tients in the control group. It was clearly demonstrated that gastric pHi returned to normal before 48 h after injury. Plasma endotoxin and TNF contents were measured, and they were significantly lower than con trol values after 72 h. In conclusion, it is believed that anisodamine might be a valuable adjunct to the resuscitation regime of burn shock , anti, therefore, a promising drug to abate endogenous endotoxaemia s ubsequent to splanchnic vasoconstriction due to hypovolaemia. The shor t-comings of the drug were a mild abdominal distention and tachycardia after its administration. (C) 1997 Elsevier Science Lid for ISBI.