Účinek ketaminu, antagonisty NMDA-receptoru, na žaludeční myoelektrickou aktivitu experimentálních prasat
Jan Bureš1,2,3, Jaroslav Květina Orcid.org 4, Věra Radochová5, Štěpán Suchánek Orcid.org 6, Stanislav Rejchrt Orcid.org 4, Martin Vališ7, Veronika Knoblochová8, Jana Žďárová Karasová Orcid.org 9, Ondřej Soukup9, Darina Kohoutová1,10
+ Pracoviště
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
ketamin, antagonista receptorů NMDA (N-metyl-D-aspartát), elektrogastrografie, myoelektrická aktivita žaludku, experimentální prase
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