The gastrointestinal effects of baclofen are limited to the proximal part of the gi tract

Abstract

To test a hypothesis that erythromycin (EM), a motilin agonist, reduces the incidence of early delayed gastric emptying (DEG) and changes gastric motility after Billroth I pylorus preserving pancreaticoduodenetomy Material and Methods: A total of 28 patients received either EM of lmg/kg in 50mL every 8 hours (n=12), or an identical volume of 0.9 % saline (n= 16) from the first to 14th postoperative day. Postoperative NG tube days, daily NG residual volume, and DGE defined as NG left in place for 10 days or emesis after NG removal, were measured. On the 30th postoperative day, gastric motility study was performed. After a 16 hr fast, a catheter containing three micro-transducers was transnasally introduced into the stomach which was connected to a Microdigitrapper portable data-logger. The frequency, duration, amplitude, and motor index of phase ill were evaluated using a computer by manual aid. Results: The EM and control groups were comparable regarding as preop-erative, intraoperative, and postoperative factors. The EM group had shorter duration of NG tube drainage (3.8:':0.2 vs. 14.9:':2.3 days), lower volume of daily NG tube residual (269.9:':94.3 vs. 563.4:':56.8 ml), and fewer DEG (16.7 vs. 62.5%). In the EM group on the 30th postoperative day, spontaneous phase ill was observed in 4 of 9 (44.4%), other five patients exhibited quiescent gastric motililty. EM induced phase III in 8 patients (88.8%). EM induced phase III in two of five patients who had completely quiescent gastric motility. The mean frequency, mean duration, mean amplitude, and motor index were similar in spontaneous phase III and EM induced phase III. Conclusion: EM of Imglkg reduced the incidence of early DGE after Bill-roth I PPPD. Phase III was already appeared in half of EM patients on the 30th postoperative day, however, others exhibited quiescent gastric mo-tililty. EM induced phase III in quiescent stomach. AGAA625