Relaxant effects of metoclopramide and magnesium sulfate on isolated pregnant myometrium: an in vitro study

• Published in: International journal of obstetric anesthesia Vol. 23; no. 2; pp. 131 - 137
• Main Authors: Tang, Y.Y, Du, Y, Ni, J, Ma, Y.S, Lin, X.M, Zhou, J
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2014
• Subjects: Adult; Anesthesia & Perioperative Care; Dopamine Agonists - pharmacology; Dopamine Antagonists - pharmacology; Ergolines - pharmacology; Female; Humans; In Vitro Techniques; Magnesium sulfate; Magnesium Sulfate - pharmacology; Metoclopramide; Metoclopramide - pharmacology; Muscle Relaxation - drug effects; Myometrial contractions; Myometrium - drug effects; Obstetrics and Gynecology; Oxytocin; Oxytocin - pharmacology; Pregnancy; Tocolytic Agents - pharmacology; Uterine Contraction - drug effects; Magnesium sulfate; Oxytocin; Metoclopramide; Myometrial contractions
• ISSN: 0959-289X; 1532-3374
• DOI: 10.1016/j.ijoa.2013.11.004

Abstract Background Metoclopramide and magnesium sulfate are extensively used agents in obstetrics. In this study, the relaxant properties of metoclopramide and magnesium sulfate on pregnant myometrium, together with the possible reversing influences of oxytocin and cabergoline (a dopamine D2 receptor agonist), were investigated. Methods Myometrial strips from 24 parturients were randomly allocated to four groups: control (Group CON), magnesium sulfate and oxytocin (Group MSO), metoclopramide and oxytocin (Group MEO), and metoclopramide and cabergoline (Group MEC). Myometrial strips were mounted on a myograph bathed in Krebs buffer. Saline (Group CON) and five incremental doses of magnesium sulfate (Group MSO) or metoclopramide (Groups MEO and MEC) were sequentially microinjected into the bath. Subsequently, oxytocin (Groups CON, MSO and MEO) or cabergoline (Group MEC) was microinjected into the bath. The myometrial contractile characteristics after each drug injection, including contractile force, interval and duration, were analyzed. Results Magnesium sulfate was more potent for prolonging myometrial contractile interval than reducing contractile force. Metoclopramide relaxed myometrial contractions by inhibiting contractile force and prolonging contractile interval in a concentration-dependent manner. Oxytocin reversed both the inhibited contractile force and the prolonged contractile interval caused by a high concentration of magnesium sulfate but accelerated the contractile interval and had no significant effect on the contractile force suppressed by metoclopramide. The relaxant effects of metoclopramide were completely reversed by cabergoline. Conclusions Both magnesium sulfate and metoclopramide relaxed myometrial contractions, and exhibited different responses to subsequent oxytocin treatment. The relaxant mechanism of metoclopramide may be via blockade of dopamine D2 receptor, which requires further investigation.