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Can Colonic Manometry Studies Be Done on the Day of Colonic Motility Catheter Placement?

Ammoury, Rana F.*; Emhardt, John D.; Aitchison, William B.; Horn, Debra S.*; Croffie, Joseph M.*

Journal of Pediatric Gastroenterology & Nutrition: September 2012 - Volume 55 - Issue 3 - p 278–282
doi: 10.1097/MPG.0b013e31824ac64c
Gastroenterology

Background and Aims: 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.

Methods: 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.

Results: 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.

Conclusions: Colonic manometry studies can be conducted as early as 4 hours following catheter placement with either propofol or sevoflurane used for anesthesia.

*Division of Pediatric Gastroenterology, Hepatology, and Nutrition

Division of Anesthesiology, Indiana University School of Medicine, Indianapolis, IN.

Address correspondence and reprint requests to Joseph M. Croffie, MD, Professor of Clinical Pediatrics, Division of Pediatric Gastroenterology, Indiana University School of Medicine, Riley Hospital for Children, Pediatric Gastroenterology, Hepatology, and Nutrition, 702 Barnhill Dr, ROC 4210, Indianapolis, IN 46202 (e-mail: jcroffie@iupui.edu).

Received 29 March, 2011

Accepted 2 December, 2011

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN