Effect of modern analgesic drugs (tramadol, pentazocine, and buprenorphine) on the bile duct sphincter in man

Modern narcotic analgesic drugs, such as tramadol, pentazocine, and buprenorphine share similarities of molecular structure with morphine which is widely believed to cause spasm of the bile duct sphincter and so impede bile flow. This study assessed the effects of intravenously administered analgesi...

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Bibliographic Details
Published in:Gut 1986-05, Vol.27 (5), p.567-569
Main Authors: Staritz, M, Poralla, T, Manns, M, Meyer Zum Büschenfelde, K H
Format: Article
Language:English
Subjects:
Adult
Ampulla of Vater - drug effects
Analgesia
Analgesics
Biological and medical sciences
Buprenorphine - pharmacology
Cholangiopancreatography, Endoscopic Retrograde
Cyclohexanols - pharmacology
Female
Humans
Male
Manometry
Medical sciences
Middle Aged
Morphinans - pharmacology
Muscle Contraction - drug effects
Neuropharmacology
Pentazocine - pharmacology
Pharmacology. Drug treatments
Sphincter of Oddi - drug effects
Tramadol - pharmacology
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Summary:Modern narcotic analgesic drugs, such as tramadol, pentazocine, and buprenorphine share similarities of molecular structure with morphine which is widely believed to cause spasm of the bile duct sphincter and so impede bile flow. This study assessed the effects of intravenously administered analgesics on bile duct sphincter motor activity measured by ERCP manometry. Ten minutes after pentazocine injection the duration of contractions and baseline pressure of the bile duct sphincter rose from 6.2 +/- 0.2 to 8.2 +/- 0.27 s and from 5.1 +/- 0.6 to 8.8 +/- 0.4 mmHg respectively. Tramadol, buprenorphine and saline showed no such effect. These data indicated that the effects of such drugs on bile duct sphincter function can be safely assessed by ERCP manometry and that pentazocine adversely affects the bile duct sphincter, whilst tramadol and buprenorphine do not. We consider therefore that pentazocine is not the premedication of first choice for endoscopic procedures involving the sphincter of Oddi and should also be avoided in patients with pancreatic and biliary disorders.
ISSN:0017-5749
1468-3288
1458-3288
DOI:10.1136/gut.27.5.567