The effect of ketamine anesthesia on anorectal manometry

Paskins, J.R.; Lawson, J.O.N.; Clayden, Graham

doi:10.1016/s0022-3468(84)80189-x

Cited by 27 publications

(15 citation statements)

References 9 publications

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“…Based on these studies, Benninga et al [17] was able to diagnose megarectum in only a minority of the constipated children in his study, whereas Clayden [18] has suggested that the percentage of chronically constipated children with MR is significantly higher. Anorectal manometry also has many disadvantages in that it is not child-friendly and may also require the use of ketamine anesthesia [19]. Verduron et al [5] using rectal elasticity studies considered patients with maximum tolerable volumes above 320 mL in women and 440 mL in men to have MR. Again, we do not have normal manometric values for normal rectal compliance in healthy children to guide us.…”

Section: Discussionmentioning

confidence: 99%

Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation

Singh¹,

Gibbons²,

Vincent³

et al. 2005

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation

Singh¹,

Gibbons²,

Vincent³

et al. 2005

Journal of Pediatric Surgery

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“…We used the anorectal manometry analyser software, AMA version 3.11, developed by author (Keshtgar) [23]. ARM under ketamine anesthesia enables young and incompliant children to be studied without affecting activities of the IAS, but voluntary contraction of the external sphincter and sensation cannot be evaluated [24]. We had studied 144 children with chronic idiopathic constipation and reported a median resting anal sphincter pressure of 54 mmHg (range 19-107) on ARM [8].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of outcome of anorectal anomaly in childhood: the role of anorectal manometry and endosonography

et al. 2008

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The aim of this study was to evaluate role of anorectal manometry (ARM) and anal endosonography (ES) in assessment of the internal anal sphincter (IAS) quality on continence outcome following repair of anorectal anomalies (ARA). We devised a scoring system to evaluate the quality of the IAS based on ARM and ES and correlated the scores with clinical outcome, using a modified Wingfield score (MWS) for faecal continence. We also assessed the implication of megarectum and neuropathy on faecal continence. Of 54 children studied, 34 had high ARA and 20 had low ARA. Children with high ARA had poor sphincters on ES and ARM, and also poor faecal continence compared to those with low ARA. The presence of megarectum and neuropathy was associated with uniformly poor outcome irrespective of the IAS quality. The correlations between MWS on one hand, and ES and ARM scores for IAS on the other hand were weak in the whole study group, ES r = 0.27, P < 0.04, and ARM r = 0.39, P < 0.004. However, the correlations were strong in those who had isolated ARA without megarectum or neuropathy, ES r = 0.51, P < 0.02 and ARM r = 0.55, P < 0.01, respectively. In conclusion, the ARM and ES are valuable in evaluation of continence outcome in children after surgery for ARA and those with good quality IAS had better faecal continence. The IAS is a vital component in functional outcome in absence of neuropathy and megarectum.

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“…The study by Paskins et al. (1) compared the effects of sedation with ketamine and ‘no sedation’ in children undergoing detailed anorectal manometry studies. These examined resting rectal tone and amplitude of rhythmic activities in the internal anal sphincter among other variables.…”

Section: Discussionmentioning

confidence: 99%

“…have demonstrated a lack of impact of general anesthesia and sedation on the rectoanal inhibitory reflex, but this effect was not evaluated during the detailed manometry performed by Paskins et al. (1,28). Based on these studies therefore, the use of ketamine alone during anorectal manometry studies remains standard in our institution.…”

Section: Discussionmentioning

confidence: 99%

Adverse events and behavioral reactions related to ketamine based anesthesia for anorectal manometry in children

Dalal

Taylor

Somerville

et al. 2008

Pediatric Anesthesia

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Our study findings suggest that, besides significantly prolonging time to spontaneous awakening and PACU discharge, neither the use of midazolam, propofol, or combinations is beneficial in preventing the occurrence of behavioral reactions following ketamine anesthesia. Behavioral reactions were common but did not appear to be long-term. Drug combinations with ketamine may have other benefits such as antiemesis.

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The effect of ketamine anesthesia on anorectal manometry

Cited by 27 publications

References 9 publications

Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation

Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation

Evaluation of outcome of anorectal anomaly in childhood: the role of anorectal manometry and endosonography

Adverse events and behavioral reactions related to ketamine based anesthesia for anorectal manometry in children

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