The Effect of Dexmedetomidine Sedation on Lower Gastrointestinal Motility in Children-Is It Suitable for Anorectal Manometry?

Autor: Berger TD; Department of Gastroenterology, Boston Children's Hospital, Boston, MA 02115, USA., Lukovits K; Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA., Cavanaugh D; Boston Biostatistical Consulting, North Reading, Haverhill, MA 01832, USA., Nurko S; Department of Gastroenterology, Boston Children's Hospital, Boston, MA 02115, USA., Mason K; Department of Anaesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Dec 04; Vol. 12 (23). Date of Electronic Publication: 2023 Dec 04.
DOI: 10.3390/jcm12237494
Abstrakt: Anorectal manometry is one of the most frequently performed gastrointestinal motility studies in children. It is an important study in diagnosing Hirschsprung disease (HD). These procedures can be uncomfortable, painful and emotionally distressing. Nitrous oxide or midazolam are the only pharmacologic options available, as clinical experience suggests that they do not alter manometry readings. Our study was designed to determine whether Dexmedetomidine (DEX) could provide adequate sedation without disrupting anal and rectal pressure. The effect of DEX on anorectal function has never been studied in children. This prospective study recorded anorectal manometry (ARM) measurements prior to the administration of DEX and then repeated the measurements at 1 and 5 min after DEX. The main ARM measurements included resting intra-anal sphincter pressure (IASP) and the presence and characteristics of the recto-anal inhibitory reflex (RAIR). DEX was administered as a bolus followed by a continuous infusion. Twenty patients were included (60% female; mean age 10.8 ± 4.6 years). The RAIR became absent in 2/16 (12.5%) patients after DEX administration. DEX may alter physiologic ARM and IASP recordings necessary to diagnose gastrointestinal medical conditions.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje