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Electrocardiography during manual dilatation of the anus
Insights
Manual anal dilatation is safe under propanidid anesthesia, with minimal cardiac events observed. Atropine did not alter heart rate changes, suggesting propanidid offers cardiac protection during visceral stimulation.
Area of Science:
- Anesthesiology
- Colorectal Surgery
- Cardiology
Background:
- Manual anal dilatation is a common procedure.
- Anesthesia can influence cardiac function during surgical procedures.
- Propanidid is an anesthetic agent with potential cardioprotective effects.
Purpose of the Study:
- To evaluate the safety and cardiac effects of manual anal dilatation.
- To assess the role of propanidid, nitrous oxide, and halothane anesthesia in this procedure.
- To determine the necessity of atropine premedication.
Main Methods:
- Fifty unpremedicated outpatients underwent manual anal dilatation.
- Anesthesia was induced using propanidid, nitrous oxide, and halothane.
- Electrocardiogram (E.C.G.) monitoring was employed throughout the procedure.
- Half the patients received intravenous atropine with propanidid.
Main Results:
- The procedure caused various heart rate changes.
- Only two isolated cardiac arrhythmic complexes were recorded: one conduction defect and one ventricular extrasystole.
- Atropine did not significantly modify heart rate alterations.
Conclusions:
- Manual anal dilatation under the described anesthesia is a safe outpatient procedure.
- Premedication with atropine is not necessary.
- Propanidid appears to mitigate cardiac abnormalities associated with intense visceral stimulation.
Abstract:
Manual dilatation of the anus was carried out on 50 unpremedicated outpatients under propanidid, nitrous oxide, and halothane anaesthesia with E.C.G.monitoring. About half of the patients received intravenous atropine with the propanidid. The operation induced a variety of changes in heart rate but in the whole experiment only two isolated cardiac arrhythmic complexes were seen-a single defect of conduction and a solitary ventricular extrasystole. Changes in rate were not modified by atropine. It is concluded that manual dilatation of the anus is a safe procedure when carried out under the anaesthetic described and that prior medication with atropine is not necessary. This work supports the view that propanidid protects patients from most abnormalities of heart action which result from intense visceral stimulation.