The effects of intravenous metoclopramide (Maxolon) on the lower oesophageal sphincter (LOS) were studied in three groups of patients, one group being normal control and the other two being pregnant females, one without heartburn and the other with.
Metoclopramide increases the LOS pressure 20.5, 15.2 and 10.2 cm H2O respectively (p<0.005, p<0.005 and p<0.05).
These findings suggest that for patients undergoing elective or emergency obstetrical anaesthesia, intravenous metoclopramide may help reduce the incidence of regurgitation of gastric contents.
References
1.
ArthureH., TomkinsonJ., OrganeG., BatesM., AdelsteinA. M., and WeatherallJ. A. L. (1969): “Report of Confidential Enquiries into Maternal Health in England and Wales”, Triennial Reports 1967-69H.M.S.O. p. 72. London.
2.
BirtleyR. D. N., and BainesM. W. (1973): “The Effects of Metoclopramide on Some Isolated Intestinal Preparations”, Post-grad. Med. J. Supp., 4, 49. p. 13.
3.
BorensteinP., and BlesG. (1965): “Clinical and Electroencephalographic Effects of Metoclopramide in Psychiatry”, Therapie, 20, 975.
4.
Brock-utneJ. G., RubinJ., DowningJ. W., DimpoulosG. E., MoshalM. G., and NaikerM. (1976): “The Administration of Metoclopramide with Atropine. (A Drug Interaction Effect on the Gastro-oesophageal Sphincter in Man)”, Anaesthesia, 31, 1186.
5.
Brock-utne (1977): “The Effect of Hyoscine on the Lower Oesophageal Sphincter”, Anaesth. Intens. Care, 5, xxx.
6.
CohenS., and LipshutzW. (1971): “Hormonal Regulation of Human Lower Oesophageal Sphincter Competence: Interaction of Gastrin and Secretin”, J. Clin. Invest., 50, 449.
7.
DonaldL. (1964): Practical Obstetric Problems. 3rd Edition. The Year Book Medical Publisher, Inc.Chicago.
8.
DowT. G. B., Brock-utneJ. G., WellmanS., DimpoulosG. E., RubinJ., and MoshalM. (1977): “The Effect of Atropine on the Lower Oesophageal Sphincter in Late Pregnancy”, Amer. J. Obstet. Gynecol. In press.
9.
HandleyA. J. (1967): “Metoclopramide in the Prevention of Post-operative Nausea and Vomiting”, Brit. J. Clin. Practice, 21, 460.
10.
HowardF. A., and SharpD. S. (1973): “Effects of Metoclopramide on Gastric Emptying during Labour”, Brit. Med. J., 1, 446.
11.
JamesW. B., and HumeR. (1968): “Action of Metoclopramide on Gastric Emptying and Small Bowel Transit Time”, Gut, 9, 203.
12.
LindJ. F., SmithA. M., McIverD. K., CooplandA. T., and CrispinJ. S., (1968): “The Effect of Atropine on the Gastroesophageal Sphincter”, Canad. J. Physiol. Pharmacol., 48, 233.
13.
MendelsonC. L. (1946): “The Aspiration of Stomach Contents into the Lungs during Obstetric Anaesthesia”, Amer. J. Obstet. Gynecol., 52, 191.
14.
ShaklaiM., PinkhasJ., and De VriesA. (1974): “Metoclopramide and Cardiac Arrhythmia”, Brit. Med. J.2, 385.
