Antroduodenal motility, ph and gastric emptying during balanced anaesthesia: Comparison of pethidine and fentanyl

Abstract

In a randomized study of 22 patients, antroduodenal motility, pH and gastric emptying rate were measured during barbiturate anaesthesia with pethidine or fentanyl. Motility was measured by manometry and gastric emptying rate by the paracetamol absorption test. Anaesthesia reduced the duration of the interdigestive motility complexes with both analgesics (P < 0.001), mainly by a shortening of phase Il (P < 0.01) The duration of phase II and III were shorter with pethidine, and pethidine reduced both the frequency and amplitudes of antral contractions during phase II (P < 0.01). Fentanyl affected only the amplitudes. The phase III variables assessed were unchanged, apart from a decrease in the velocity of propagation of the motility complexes with pethidine (P < 0.01). The gastric pH increased in both groups during and after operation (P < 0.01). Gastric emptying rate was normal in 82% with fentanyl and in 60% with pethidine. Motility in the recovery period approached, but did not reach, preoperative values. Balanced anaesthesia with pethidine and fentanyl seem to have minor influence on gastroduodenal motility and gastric emptying rate. © 1989 British Journal of Anaesthesia.