A comparison of the effect on gastric emptying of propofol or dexmedetomidine in critically ill patients

Background

Propofol and dexmedetomidine are widely used for sedation in the ICU, but there are limited data on the effects on gastric motility. In our study, we aim to establish whether or not the propofol and dexmedetomidine effect of gastric emptying is preserved in critically ill patients.

Method

The study involved 24 critically ill, enterally fed adult patients. Each patient received enteral feeding via a nasogastric tube at 50 ml/hour throughout the 5-hour study period – either propofol 2 mg/kg/hour (n = 12, Group P) or dexmedetomidine 0.2 μg/kg/hour (n = 12, Group D) intravenously over 5-hour infusion. Gastric motility was measured indirectly by analysis of the absorption over time 1.5 g paracetamol administered into the stomach at the start of the study period. At the beginning and end of the study, the residual gastric volume and pH were measured. The rate of gastric emptying is proportional to the area under the line plot of serum paracetamol concentration over 120 min (AUC120).

Results

The gastric residual volume measured at the end of propofol infusion (11.33 ± 4.84) was found to be higher when compared with the volume measured before infusion (19.33 ± 11.33) and after dexmedetomidine infusion (9.17 ± 4.54). But, there was no difference between groups in the gastric emptying time (AUC 120 894.53 ± 499.39 vs 1113.46 ± 598.09, Group P and Group D, respectively).

Conclusion

In patients with high gastric residual volume, dexmedetomidine infusion can be the preferred sedative agent.