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Effect of propofol on anal sphincter pressure during anorectal manometry

Khoa Tran1, Brad Kuo, Audrius Zibaitis

  • 1*Department of Pediatric Gastroenterology, New England Medical Center †Gastroenterology Unit, Massachusetts General Hospital ‡Department of Anesthesia §Division of Gastroenterology, Hepatology, and Nutrition, Massachusetts General Hospital for Children, Harvard Medical School, Boston.

Journal of Pediatric Gastroenterology and Nutrition
|October 15, 2013
PubMed

Insights

Propofol significantly lowers resting anal sphincter pressure (RP) in children undergoing anorectal manometry for chronic constipation. Caution is advised when using propofol, as it can affect RP measurements.

Area of Science:

  • Pediatric Gastroenterology
  • Anesthesiology
  • Physiology

Background:

  • Anorectal manometry is a key diagnostic tool for chronic constipation in children.
  • General anesthesia is often required for pediatric anorectal manometry.
  • The effects of anesthetic agents on anal sphincter pressure are not fully understood.

Purpose of the Study:

  • To evaluate the impact of propofol on resting anal sphincter pressure (RP) in children with chronic constipation undergoing anorectal manometry.

Main Methods:

  • Twenty children with chronic constipation underwent anorectal manometry.
  • Propofol was administered as a bolus under general anesthesia.
  • Resting anal sphincter pressure was measured before and after propofol administration.

Main Results:

  • Propofol administration led to a significant decrease in RP in 95% of children.
  • Mean RP decreased from 51.5 ± 15.3 mmHg to a nadir of 21.7 ± 10.5 mmHg (P < 0.001).
  • Post-propofol RP (47.0 ± 12.4 mmHg) remained significantly lower than pre-propofol levels (P < 0.0001).

Conclusions:

  • Propofol significantly reduces resting anal sphincter pressure during anorectal manometry in children.
  • Anesthetic use of propofol may confound RP measurements in pediatric anorectal manometry.
  • Caution is recommended when using propofol for this procedure due to its effect on RP.

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