Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Indiana University School of Medicine, Indianapolis, USA.
J Pediatr Gastroenterol Nutr. 2012 Sep;55(3):278-82. doi: 10.1097/MPG.0b013e31824ac64c.
Colonic manometry has been used to assess colonic neuromuscular integrity in pediatric patients with severe constipation unresponsive to standard medical therapy and to tailor their treatment plans. There are presently no available standard protocols for conducting colonic manometry studies. The aim of the present study was to determine whether colonic manometry studies can be conducted on the same day the colonic motility catheters are placed and to compare the effects of inhaled sevoflurane versus intravenous propofol, used during catheter placement, on colonic motility.
Twenty patients, randomized to receive sevoflurane or propofol during catheter placement, underwent colonic manometry on the day of catheter placement as well as the day after. The total motility index (MI), change in MI in response to a meal and bisacodyl, and presence of high-amplitude propagating contractions were compared between the 2 studies for each patient.
Ten patients were allocated to sevoflurane and 10 patients to propofol. A total of 8 (80%) patients in the sevoflurane group and 9 (90%) patients in the propofol group had no differences in their studies between days 1 and 2 when the tracings were interpreted manually for gross evidence of high-amplitude propagating contractions and gastrocolonic reflex. Similarly, there was no change in the total MI between studies done on days 1 and 2 in either sevoflurane (978 ± 232 vs 978 ± 184; P = 0.99) or propofol (968 ± 200 vs 1078 ± 227; P = 0.29) group. When comparing change in MI in response to a meal or bisacodyl between the 2 days, there was no statistical difference noted in either group.
Colonic manometry studies can be conducted as early as 4 hours following catheter placement with either propofol or sevoflurane used for anesthesia.
结肠测压已用于评估对标准药物治疗无反应的严重便秘的儿科患者的结肠神经肌肉完整性，并制定其治疗计划。目前尚无进行结肠测压研究的标准方案。本研究旨在确定是否可以在放置结肠测压导管的同一天进行结肠测压研究，并比较在导管放置过程中使用吸入七氟醚与静脉注射异丙酚对结肠动力的影响。
20 名患者随机分为在导管放置过程中接受七氟醚或异丙酚的患者，在导管放置当天和次日进行结肠测压。比较每位患者两次研究的总运动指数（MI）、对餐和比沙可啶的 MI 变化以及高振幅传播收缩的存在情况。
10 名患者分配到七氟醚组，10 名患者分配到异丙酚组。当手动解释记录以寻找高振幅传播收缩和胃结肠反射的明显证据时，七氟醚组有 8 名（80%）患者和异丙酚组有 9 名（90%）患者在第 1 天和第 2 天的研究中没有差异。同样，在七氟醚组（978 ± 232 对 978 ± 184；P = 0.99）或异丙酚组（968 ± 200 对 1078 ± 227；P = 0.29）中，第 1 天和第 2 天的研究之间总 MI 无变化。当比较两天之间对餐或比沙可啶的 MI 变化时，两组均无统计学差异。
在使用麻醉的情况下，在放置导管后 4 小时内即可进行结肠测压研究。
