Effects of Prokinetic Agents on Motility of Proximal and Distal Colon

Mehmet Arslan, Ahmet ALTUN, Cengiz GÜNEY, Levent Cankorkmaz, İhsan Bağcıvan, Gökhan KÖYLÜOĞLU

Özet

Objective: It is known that prokinetic agents increase the motility of stomach and intestine. Although there are many studies on the motility of colon, its mechanism is not well clarified. The aim of this study to investigate the effects of prokinetic agents on proximal and distal colon tissues.Methods: Forty male wistar albino rats were allocated into five groups. Rats divided five group as a control, erythromycin, ampicillin, domperidon and metoclopramide. Before taking the tissue samples, this four agents were given by oral gavage, three times a day. The proximal and distal colon tissues were taken after the sacrification of rats, the colonic segments were mounted in 10 ml organ baths in the direction of circular muscles, and the contractions were recorded by a polygraph. The changes in the amplitude (% of KCl) and frequency (number/min) of contractions were analyzed before and after the addition of antagonists. The antagonist responses were taken by L-NNA, indomethacin, nimesulid, hexamethonium and tetradotoxin.Results: While investigating the mechanism of the contraction changes, L-NNA, indomethacin, nimesulid significantly increased the amplitude of both proximal and distal colon spontaneous contractions compared with control group but hexamethonium and tetradotoxin did not. According to the frequency responses, the erythromycin group responses were significantly higher than control group.Conclusions: Erythromycin, ampicillin, domperidon and metoclopramide may be useful to increase the motility of gastrointestinal system. On the other hand, the use of these agents in combination with nitric oxide synthase inhibitors and prostaglandin synthesis inhibitors may increase the effects of these agents.Key words: Prokinetic agents, colon, motility, amplitude, frequency

Abstract

Objective: While there are suggestions for oral hydration times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge.Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital admission.Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported.Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.Key words: Sedation, oral intake, postoperative nausea and vomiting