Effect of narcotics on C.B.D. pressure

ABSTRACT

Many reports have studied the effect of narcotics on the terminal bile ducts and oddi's Sphincter, which demonstrate that narcotics mainly morphine produce slow and prolonged increase in common bile duct pressure. The aim of our study was to compare between the effects on the common bite duct pressure of either intravenous bolus or intermittent injection of equianalgesic doses of commonly used narcotics mainly Fentanyl, Meperidine and Nalbuphine during cholecystectomy operations. Sixty patients scheduled for elective cholecystectomy were participated to the study the effect of equianalgesic doses of Fentanyl, Mepredin and Nubain either in the form of bolus or intermittent way. Premedication with 10 mg valium only. After anaesthesia and exploration, the cystic duct cannulated and measurement of the interacholiedochal pressure by modified caroli apparatus. Comparing the predrug value and postdrug. value indicate that there is significant increase in the common bile duct pressure in both Fentanyl and Meperidine when the drugs given in bolus way, while if given through intermittent method only the meperidin raise the pressure while the fentanyl did not increase the Pressure. Nubain did not cause any increase in the common bile duct pressure either if it is given on bolus or intermittent method: