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ANESTHETIC PHARMACOLOGY

Propofol and Midazolam Inhibit Gastric Emptying and Gastrointestinal Transit in Mice

Department of Anesthesiology, Kansai Medical University, Osaka, Japan

Address correspondence and reprint requests to Takefumi Inada, MD, Department of Anesthesiology, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan. Address e-mail to takefumi{at}wd5.so-net.ne.jp

We studied the effect of propofol and midazolam on gastric emptying and gastrointestinal transit in mice. Ten minutes after intraperitoneal injection of propofol or midazolam, 0.2 mL of saline containing fluorescent microbeads was infused into the stomach. Thirty minutes later, the gastrointestinal tract was excised, and gastric emptying and gastrointestinal transit were calculated by measuring the quantity of fluorescent microbeads in the gastrointestinal tract by using a flow cytometer. At a dose that produced a light level of sedation (mice righted themselves within 2 s), both drugs significantly, but weakly, inhibited gastric emptying to a similar degree (propofol: P < 0.001 versus control value; 95% confidence interval [CI] for difference, 4.9%–20.2%; midazolam: P < 0.001 versus control value; 95% CI for difference, 7.8%–14.7%). Midazolam, but not propofol, delayed gastrointestinal transit (P < 0.001). At a larger dose that produced a deeper level of sedation (absence of righting reflex >10 s), both drugs significantly inhibited gastric emptying (propofol: P < 0.001; 95% CI for difference, 31.4%–61.2%; midazolam: P < 0.001; 95% CI for difference, 30.8%–61.1%) and gastrointestinal transit (P < 0.001 for both drugs).

IMPLICATIONS: For patients whose lungs are mechanically ventilated, propofol or midazolam may be used to produce sedation. At a light level of sedation, propofol may be preferable to midazolam because of its weaker inhibitory effect on gastrointestinal transit. With an increasing depth of sedation, such an advantage may be reduced.

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