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ANESTHETIC PHARMACOLOGY

The Delay of Gastric Emptying Induced by Remifentanil Is Not Influenced by Posture

Jakob Walldén, MD^*,, Sven-Egron Thörn, MD PhD^*, and Magnus Wattwil, MD PhD^*,

*Department of Anesthesia and Intensive Care, Örebro University Hospital, Örebro, Sweden; and Department of Medicine and Care, Faculty of Health Sciences, Linköping, Sweden

Address correspondence to Jakob Walldén, MD, Department of Anesthesia and Intensive Care, Örebro University Hospital, 701 85 Örebro, Sweden. Address e-mail to jakob.wallden{at}tele2.se Address reprint requests to Magnus Wattwil, MD, PhD, Department of Anesthesia and Intensive Care, Örebro University Hospital, 701 85 Örebro, Sweden. Address e-mail to magnus.wattwil@orebroll.se.

Posture has an effect on gastric emptying. In this study, we investigated whether posture influences the delay in gastric emptying induced by opioid analgesics. Ten healthy male subjects underwent 4 gastric emptying studies with the acetaminophen method. On two occasions the subjects were given a continuous infusion of remifentanil (0.2 µg · kg^–1 · min^–1) while lying either on the right lateral side in a 20° head-up position or on the left lateral side in a 20° head-down position. On two other occasions no infusion was given, and the subjects were studied lying in the two positions. When remifentanil was given, there were no significant differences between the two postures in maximal acetaminophen concentration (right side, 34 µmol · L^–1; versus left side, 16 µmol · L^–1), time taken to reach the maximal concentration (94 versus 109 min), or area under the serum acetaminophen concentration time curve from 0 to 60 min (962 versus 197 min · µmol · L^–1). In the control situation, there were differences between the postures in maximal acetaminophen concentration (138 versus 94 µmol · L^–1; P < 0.0001) and area under the serum acetaminophen concentration time curves from 0 to 60 min (5092 versus 3793 min · µmol · L^–1; P < 0.0001), but there was no significant difference in time taken to reach the maximal concentration (25 versus 47 min). Compared with the control situation, remifentanil delayed gastric emptying in both postures. We conclude that remifentanil delays gastric emptying and that this delay is not influenced by posture.

IMPLICATIONS: In healthy volunteers, remifentanil 0.2 µg · kg^–1 · min^–1 delayed gastric emptying, and there were no differences in this delay between 2 extreme postures (right lateral head-up and left lateral head-down position). Our results indicate that the remifentanil-induced delay in gastric emptying is not influenced by posture.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999