Normal gallbladder ejection fraction after morphine augmentation

Purpose: Morphine sulfate causes spasm of the sphincter of Oddi, Conversely , the cholecystagogue sincalide produces relaxation of the sphincter and co ntraction of the gallbladder, This prospective study evaluated whether sinc alide could produce normal gallbladder emptying after low-dose morphine sul fate (0.04 mg/kg), Methods: Thirty to 120 minutes (mean, 51 minutes) after morphine sulfate-au gmented gallbladder visualization, 25 gallbladder ejection fractions in 24 patients were measured. One patient was studied twice, 2 weeks apart. Gallb ladder ejection fractions were calculated after controlled 30-minute infusi ons of sincalide (0.02 mu g/kg), Results: Fourteen gallbladder ejection fractions were normal (mean, 63%; ra nge, 45% to 80%) and 11 gallbladder ejection fractions were abnormal (mean, 12%; range, 5% to 19%; P < 0.001), Conclusions: Normal gallbladder ejection fractions can be obtained as early as 30 minutes after administration of low-dose morphine sulfate. Potential applications of post-morphine sulfate sincalide challenge would include, f or example, to support true-negative morphine sulfate-augmented gallbladder visualization in a patient with a high clinically indicated potential of h aving acute cholecystitis.