Effect of Intravenous Scopolamine Butylbromide on Antroduodenal Motility in Humans: Non-Invasive Observations with Real-Time ultrasound

靜脈注射Scopolamine Butylbromide對人類胃十二指腸蠕動之作用：非侵犯性超音波之觀察

粘惠美(Huei-Mei Nain) ； 黃志焜(Chih-Kuen Huang) ； 陳儉鏗(Gran-Hum Chen) ； 萬居仁(Jyn-Rern Wahn) ； 鄭毓平(Yu-Ping Cheng) ； 潘錫光(Sek-Kwong Poon) ； 劉振華(Jehn-Hwa Liu) ； 何家奭(Ka-Sci Ho) ； 張繼森(Chi-Sen Chang)

《中華民國消化系醫學會雜誌》 12卷4期 (1995/12) Pp. 304-309

https://doi.org/10.6557/GJTa.199512_12(4).0003

摘要

Scopolamine butylbromide (Buscopan)是膽齡素(acetylcholine)之競爭性抑制劑，被用來當作胃腸道之抗痙攣劑。且目前廣汜地被使用在內視鏡之術前給藥。本研究是利用超音波去直接觀察靜脈注射Buscopan如何影響飯後胃十二指腸之蠕動。共有8個自願者進入本研究。結果顯示靜脈注射Buscopan可以立刻造成胃十二指腸蠕動停止（沒有觀察到胃之蠕動或輕幽門之流動），持續719.50±173.36秒。當胃收縮波又被觀察到縣城恢復規則性收縮時，與對照組比較，Buscopan組之胃收縮週期沒有改變，但是經幽門順流及逆流之次數及時間顯著減少。我們的結論是靜脈注射擊Buscopan可以立刻造成飯後胃十二指腸之蠕動停止，且持續約12分鍾之久。膽齡素路徑在控制胃十二指腸之蠕動扮演著重要之角色，而這種作用會被抗膽鹼素(anticholinergic)-Buscopan所阻斷。

關鍵字

胃腸蠕動 ； 抗膽齡素 ； 超音波

並列摘要

Scopolamine butylbromide (Buscopan), a competitive antagonist of acetylcholine at the muscarinic receptor; is used as an antispasmodic and is a popular premedication for panendoscopic examinations. To evaluate the pharmacological effects of Buscopan on gastroduodenal motility, we used real-time ultrasound (sector probe, 3.5 MHz) to observe postprandial liquid-phase antroduodenal motility in eight healthy volunteers. Following intravenous administration of 20 mg Buscopan, an immediate onset of a period of ”silent stomach” (defined as no observed gastric peristalsis or transpyloric fluid flow) was observed in all subjects and lasting for 719.50±173.36 seconds. Although visible and regular gastric peristalsis did return, forward and retrograde transpyloric flow episodes and durations were significantly decreased. Thus, we conclude that an intravenous injection of 20 mg Buscopan has an immediate effect on antroduodenal motility producing a silent stomach for a duration of about 12 minutes. We find that cholinergic pathways play a major role in controlling antroduodenal motility. The anticholinergic agent, Buscopan, has been found to effectively block these cholinergic pathways which can cause antroduodenal motility and gastric distress.

並列關鍵字

antroduodenal motility ； anticholinergic ； ultrasound.