By M. Schemann, D. Reiche, M. Neunlist (auth.), Priv.-Doz. Dr. M. K. Herbert, Professor Dr. P. Holzer, Professor Dr. N. Roewer (eds.)
After a protracted interval of forget, the gastrointestinal tract is more and more being recog nized as a big objective of anesthetics and anesthesia-related techniques, in addition to of stipulations and coverings relating to peri- and postoperative interval and inten sive care. medications utilized in anesthesia and in depth care and physiological or pathologi cal alterations within the perioperative interval have an effect on the digestive procedure in its functionality from the pharynx to the colon. lengthy postoperative ileus or stasis of propulsive peri stalsis within the seriously in poor health or multiply injured sufferer could impair enteral meals and provides upward push to problems resembling sepsis or a number of organ failure. In view of this new realizing of the medical relevance of intestine functionality, we felt booklet on difficulties of the gastrointestinal tract in anesthesia, the perioperative interval, and extensive care was once badly wanted. the current quantity is the manufactured from a world symposium which introduced jointly physiologists, pharmacologists, experimental and medical anesthetists, gastroenterologists, surgeons, and in depth care physicians to debate all significant modern points of bowel functionality in healthiness and below the impact of anesthesia, surgical procedure, and in depth care.
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Additional resources for Problems of the Gastrointestinal Tract in Anesthesia, the Perioperative Period, and Intensive Care: International Symposium in Würzburg, Germany, 1-3 October 1998
Erythromycin (Peeters 1993) has an effect similar to that of motilin and acts on motilin receptors. Although erythromycin has no effect on canine gastric strips in vitro, it accelerates gastric emptying in conscious dogs by inducing forceful gastric contractions. These strong contractions prevent the normal sieving function of the antropyloroduodenal region. The physiological relevance of this observation remains to be determined. In patients with severe gastroparesis, such as that seen in diabetic neuropathy, motilin and erythromycin are both effective in accelerating gastric emptying.
1997), is presumably mediated by [l-opioid receptors (Arzet et al. 1998b). Whether the lack of a b-receptormediated effect of DPDPE is species dependent or due to the absence of b-opioid receptors in the guinea-pig ileum remains open. Ketamine, another drug with potent analgesic properties, provides a good alternative to opioids under clinical conditions. The experiments concerning their effect on ileal motility revealed that racemic as well as the S( +) enantiomer of ketamine inhibited the intestinal reflex in a concentrationdependent manner, but about 1,000-fold concentrations of ketamine were required compared with fentanyl to completely abolish intestinal motility (Herbert et al.
1-100nM) brought about a concentration-dependent reduction of the pressure threshold to elicit a peristaltic wave and increased the frequency of contractions. With 100 nM cerulein the frequency of contractions was more than doubled over the entire observation period (Herbert et al. 1998c). Metoclopramide has either no effect or an inhibitory effect on peristalsis in the small intestine in vitro (Kuhn et al. 1998). J-M did not affect the pressure threshold or the frequency of contractions. J-M metoclopramide the peristalsis parameters remained unchanged in 5 of 10 segments, whereas in the other 5 segments the contractions were completely abolished (Kuhn et al.