Effect Of Morphine Anisodamine And Magnesium Sulfate On The Sphincter Of Oddi

Sphincter of Oddi (so) is very important in maitaining the normal bile duct pressure, promoting gallbladder to excrete and preventing from reflux. The function of SO has significance in diagnosis and predicotion of biliary and pancreatic disease, if it is has sphincter of Oddi dysfuction ( SOD) , the infection of bile duct and cholelithiasis will happen. At the same time, these diseases affect the function of SO, too, Sphincter of Oddi Manometry is the golden standard to examine SOD. Now it is common to measure the pressure of SO via Endoscopic retrograde cholangio pancreatographic (ERCP) intubation directly, however the rate of acute pancreatitis happening is higher, may extend to 17%. It is difficult to operate and it is often to lend to into failure. Therefore we studied the SO through cholangiscope manometry, its advantage is accurate location of catheter, less injure to the Sphincter of Oddi, SO the result should be more reliable, the lower complication of pan-creatitis, not extend to 10% , there are many drugs that affect the function of SO, in our study we will observe the affect of Morphine anisodamine and magnesium sulfate on SO by choledochofiberoscope.Material1. Patients; 30patients with hepatolith and choledoche-lithiasis are involu-ed in present study, were divided into three groups: morphine anisodamine and Magnesium Sulfate group.2. Apparatus:(1) PENTAX choledochofiberoscope.(2) Atriple-lumen catheter with outer diameter of 1. 7mm, length of 200cm.(3) Low-compliance hydraulic infusion system.(4) Polygram pressure recorder.3. Drugs;Morphine10mg per ampul; Anisodamine 10mg per ampul; 25% Magnesium Sulfate 20ml per ampulMethods1. Apparatus preparedness: First , we set up the index of computer system.2. Measurement: The patient was placed in a supir position and T-shape tube was remored. The cholangioscope was inset through sinus of T-shape tube and other manometry catheter was placed in duodenum and bile duct respectively through basket hold of cholangioscope.3. Drug application; The patients in Morphine group were injected lOmg morphine and measured the pressure curve at 10 min and 20 min, respectively . The patients in anisodamine group were injected mucle 10mg morphine and measured the pressure curve at 10 min, subsequently, injected 15 mg anisodamine to muscle, after 10 min, repeated, the measureing process . The Patients in Magnesium Sulfate group, injected Morphine 10mg and then measured the pressure at 10 min interval, subsequently, the patients took orally 25% Magnesium Sulfate 10g, at 10 min repeat the measuring process.4. parameters:(1) Pressure of duodenum.(2) Pressure of common bile duct.(3) Basal pressure of SO.(4) SO cotraction frequency.(5) SO contraction Amplitude.(6) SO contraction duration 5. Statistical analysisObserving the Morphine group ,we used t-test' in group, the group of ani-sodamine and Magnesium Sulfate, t-test' between groups were made using.Results1. Effect of morphine on Sphincter of Oddi:( 1) Effect on basal sphincter of Oddi pressure.The adminstration of 10 mg of Morphine , there was a significant increase, there was a significant increase at 10 and 20 min ,the average was 22.23 ± 16.04 and 20.51 ±13.46mmHg.(2 ) Effect on Sphincter of Oddi contraction AmplitudeThere was a significant increase at 10 min and at 20min after administera-tion of 10 mg of Morphine, the average is 104.97 ±49.15 mmHg and 88.04 ± 62.37 mmHg.( 3 ) Effect on sphincter of Oddi contraction FrequencyThere was a significant increase at 10 min and 20 min after adminiatration of 10 mg of Morphine , the mean was 9. 29 ± 1. 93 and 8. 85 ±2.42 per min, respectively.2. Effect of anisodamine on sphincter of Oddi:(1) Effect on basal pressure of sphincter of OddiThere was a significant decrease at lOmin after the administration of 15mg of anisodamine , the mean was 11.69 ±7.88 mmHg.(2) Effect on sphincter of Oddi AmplitudeAfter the administraction of 15mg anisodamine, the...