Účinek ketaminu, antagonisty NMDA-receptoru, na žaludeční myoelektrickou aktivitu experimentálních prasat

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Autoři: J. Bureš ^1,2,3 ; J. Květina ¹ ; V. Radochová ⁴ ; Miroslav Zavoral ^2,3 ; Štěpán Suchánek ^2,3 ; S. Rejchrt ⁵ ; M. Vališ ⁶ ; Knoblochova V. ¹; J. Žďárová Karasová ^1,7 ; Soukup O. ¹; D. Kohoutová ^1,8
Působiště autorů: Biomedical Research Centre, University Hospital Hradec Králové ¹; Institute of Gastrointestinal Oncology, Military University Hospital Praha ²; Department of Medicine, Charles University, First Faculty of Medicine, Praha and Military University Hospital Praha ³; Animal Laboratory, University of Defence, Faculty of Military Health Sciences, Hradec Králové ⁴; 2nd Department of Internal Medicine – Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové ⁵; Department of Neurology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové ⁶; Department of Toxicology and Military Pharmacy, University of Defence, Faculty of Military Health Sciences, Hradec Králové ⁷; The Royal Marsden NHS Foundation Trust, London ⁸
Vyšlo v časopise: Gastroent Hepatol 2022; 76(4): 309-318
Kategorie: Klinická a experimentální gastroenterologie: původní práce
doi: https://doi.org/10.48095/ccgh2022309

Souhrn

Úvod: Téměř všechny preklinické studie u experimentálních prasat je třeba provádět v celkové anestezii. Ketamin je běžně používán jako úvod do anestezie. Avšak dosud nezodpovězenou otázkou je, zda ketamin, antagonista NMDA-receptorů, ovlivňuje motorické funkce žaludku. Cílem této práce bylo vyšetřit žaludeční myoelektrickou aktivitu prasete metodou elektrogastrografie (EGG). Metody: Do studie bylo zařazeno 17 samic Sus scrofa f. domestica (průměrná hmotnost 36,2 ± 3,8 kg). Pro úvod do anestezie byla použita různá léčiva: skupina A (n = 5): medetomidin 0,1 mg/kg i. m.; butorfanol 0,3 mg/kg i. m.; midazolam 0,3 mg/kg i. m.; skupina B (n = 6): azaperon 2,2 mg/kg i. m.; skupina C (n = 6): ketamin 20 mg/kg i. m.; azaperon 2,2 mg/kg i. m. Celková anestezie ve všech skupinách pokračovala podáváním 1% propofolu (opakované 1ml bolusy, celkem 10–12 ml i.v.). Záznam EGG začal za 15 min. po úvodu do anestezie a trval 30 min. Výsledky byly vyhodnoceny jako dominantní frekvence pomalých žaludečních vln (DF) a plochy pod křivkou (EGG power). Výsledky: Celkem bylo vyhodnoceno 510 jednominutových EGG intervalů (každý dvakrát: DF a power). DF byly (průměr ± směrodatná odchylka): 1,4 ± 0,4 (skupina A), 1,3 ± 0,3 (skupina B) a 0,2 ± 0,1 cykly/min. (skupina C). Rozdíly mezi skupinou C a skupinami A a B byly statisticky významné (p < 0,001). Mediány ploch pod křivkou (IQR) byly: 0,13 (0,02–0,44; skupina A); 0,13 (0,03–0,54; skupina B) a 0,30 V² (0,07–1,44; skupina C). Rozdíl mezi skupinami A a C byl na hranici statistické významnosti (p = 0,066; chyba 2. typu beta 0,295). Závěry: Ketamin, a to i v jedné intramuskulární dávce, ovlivňuje myoelektrické funkce žaludku prasete. Proto by neměl být používán v preklinických studiích gastrointestinální motility experimentálních prasat.

Klíčová slova:

elektrogastrografie – ketamin – antagonista receptorů NMDA (N-metyl-D-aspartát) – myoelektrická aktivita žaludku – experimentální prase

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