10 唾液分泌機能に対する麻酔前投薬の影響(第516回大阪歯科学会例会)

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During anesthesia, muscarinic parasympathetic antagonists can be used as a preoperative medication on order to reduce salivary flow, tracheobronchial secretions, and pharyngeal secretions, as well as to decrease the acidity of gastric secretions. We did an in vivo study to examine whether muscarinic receptor subtypes play a role in the exocrine function of the rat submandibular gland. The effects of atropine, pirenzepine, methoctramine, 4-diphenylacetoxy-N-dimethylpiperidinium (4-DAMP) and glycopyrrolate were examined on secretion from the submandibular gland evoked by acetylcholine in pentobarbital-anesthetized rats. Glycopyrrolate caused less elevation in heart rate compared with other anticholinergics. Atropine, 4-DAMP and glycopyrrolate markedly inhibited acetylcholine-evoked fluid responses. Pirenzepine showed significantly lower inhibitory potency than atropine, 4-DAMP or glycopyrrolate, while methoctramine had even less of an inhibitory effect. Pirenzepine, 4-DAMP and glycopyrrolate significantly inhibited both protein concentration and amylase activity in the acetylcholine-evoked submandibular saliva, while methoctramine did not affect the responses. The reduction of the protein concentration and amylase activity in submandibular saliva caused by pirenzepine, 4-DAMP and glycopyrrolate were inhibited by N^G-Nitro-L-arginine methyl ester (L-NAME). Thus, it might be effective to administer anticholinergic drugs together with L-NAME as premedication. These results suggest that glycopyrrolate significantly decreases the salivary secretion, and has significantly fewer side effects than other muscarinic parasympathetic antagonists. Further controlled studies are required to determine the safety, efficacy and patient tolerance of glycopyrrolate.
大阪歯科学会の論文
2009-03-25

10 唾液分泌機能に対する麻酔前投薬の影響(第516回大阪歯科学会例会)

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10 唾液分泌機能に対する麻酔前投薬の影響(第516回 大阪歯科学会例会)

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10 唾液分泌機能に対する麻酔前投薬の影響(第516回大阪歯科学会例会)