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CRITICAL CARE AND TRAUMA

The Effect of Propofol on Human Gastric and Colonic Muscle Contractions

Tat-Leang Lee, FFARACS^*,, Sophia B. L. Ang, MMed (Anaesthesia), Yoswa M. Dambisya, MB, PhD^*, Ganesan P. Adaikan, PhD, DSc, and Lang-Chu Lau, MSc

Departments of *Anaesthesia and Obstetric and Gynaecology, National University of Singapore; and Department of Anaesthesia, National University Hospital, Singapore

Address correspondence and reprint requests to Tat-Leang Lee, Department of Anaesthesia, 5 Lower Kent Ridge Rd., National University Hospital, Singapore 119074. Address e-mail to analeetl @nus.edu.sg.

Although propofol is widely used for sedation in the intensive care unit, there are limited data on its effects on gastrointestinal motility. For that reason, we studied the in vitro effects of propofol on human gastric and colonic smooth muscle. Grossly normal human gastric and colonic muscle strips were mounted in an organ bath set-up for isometric contraction and stimulated by acetylcholine (Ach), using a cumulative dose schedule in the absence or presence of different concentrations of propofol [1.7 x 10^-6 M (0.3 µg/mL) to 4.4 x 10^-4 M (78 µg/mL)]. Ach led to concentration-dependent contraction of both gastric and colonic muscle strips, whereas propofol, at a concentration 6.7 x 10^-6 M (1.2 µg/mL) and above, significantly depressed Ach-induced contraction in a concentration-dependent manner for both smooth muscle preparations. In addition, propofol, at a concentration 2.7 x 10^-5M (4.8 µg/mL) and above, depressed spontaneous contractile activity of both smooth muscle preparations. Fat emulsion 10% (Intralipid®), the solvent for propofol, had no effect on either the spontaneous activity or the Ach-induced contraction of gastric and colonic smooth muscles.

Implications: The success of enteral feeding requires a normal gastrointestinal motility. We found that, at clinically relevant concentrations, propofol impaired gastrointestinal contractile activity. Further investigations are required to determine the clinical significance of this change.

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