Metoclopramide in gastroesophageal reflux of infancy
| Autor: | H.M. Machida, D.G. Gall, R. B. Scott, David Forbes |
|---|---|
| Rok vydání: | 1988 |
| Předmět: |
Male
Metoclopramide Exacerbation Irritability Placebo Ph monitoring law.invention Esophagus Double-Blind Method Randomized controlled trial law Pressure medicine Esophagitis Humans business.industry Reflux Infant Hydrogen-Ion Concentration Prone position Anesthesia Pediatrics Perinatology and Child Health Gastroesophageal Reflux Female Esophagogastric Junction medicine.symptom business medicine.drug |
| Zdroj: | The Journal of Pediatrics. 112:483-487 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/s0022-3476(88)80345-7 |
| Popis: | This study examined the effect of metoclopramide on lower esophageal sphincter (LES) pressure, and frequency and duration of reflux episodes in 28 children (mean age (+/- SD) 9 +/- 11 months) referred for evaluation of gastroesophageal reflux (GER). Esophageal manometry was performed before and after one intravenous dose of metoclopramide (0.125 mg/kg), and esophageal pH was monitored over a 24-hour baseline period, followed by oral metoclopramide therapy (0.125 mg/kg four times a day, for 24 hours.) During pH monitoring, patients received diet for age and were kept in the prone position with the head elevated 45 degrees while sleeping. Eight patients entered a 6-month double-blind, placebo-controlled trial of metoclopramide. Metoclopramide significantly (P = 0.04) increased end-expiratory LES pressure, from 14.9 +/- 7.5 mm Hg to 18.6 +/- 6.8 mm Hg. However, there was a significant (P less than 0.05) increase in the number of reflux episodes/24 hours, and no significant change in percentage of time pH was less than 4, number of episodes lasting greater than 5 minutes, or the longest episode of reflux between the 24-hour baseline and M periods. LES pressure did not correlate well with any of these measurements (r = 0.2). In the controlled trial, the three patients receiving metoclopramide, but none of those receiving placebo, were withdrawn by their parents because of exacerbation of GER symptoms and marked irritability (P = 0.01). In the placebo group, symptoms improved in four infants, but did not change in one. The use of metoclopramide in the treatment of GER of infancy needs to be reconsidered. |
| Databáze: | OpenAIRE |
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