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Effect of Propofol on Internal Anal Sphincter Pressure During ARM

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ClinicalTrials.gov Identifier: NCT01793753
Recruitment Status : Completed
First Posted : February 18, 2013
Last Update Posted : September 14, 2016
Sponsor:
Information provided by (Responsible Party):
Jaime Belkind-Gerson, MD, Massachusetts General Hospital

Brief Summary:

Background and Aim: An anorectal manometry (ARM) is a common test in the evaluation of outlet obstruction in constipation. In children under 6 yo, anesthesia is often used for patient comfort and compliance. The choice of anesthesia for ARM varies from center to center and includes the use of ketamine, inhalation agents, and propofol. With the increased use of propofol, our aim is to determine the effects of propofol on resting anal sphincter pressure while performing an ARM under general anesthesia.

Hypothesis: Propofol administration leads to a decrease in internal anal sphincter pressure.

Methods: This is a prospective, single center, observational study of the effect of propofol on the internal anal sphincter pressure. Pediatric patients between the ages of 2-6 years who require an anorectal manometry for chronic constipation will be offered enrollment. Anesthesia was required for patient compliance and comfort and conducted by an anesthesiologist. Sevoflurane was the inhalational agent used for induction. At Massachusetts General Hospital (MGH), 1 mg/kg of propofol bolus is routinely given at completion of the ARM test to reduce emergence delirium. The manometric probe was kept in place with continuous measurement of baseline internal anal sphincter pressure while propofol was administered. We measured changes to internal anal sphincter pressure and time to return to baseline.

Results: The primary outcomes will be change of internal anal sphincter pressure from baseline and time to return to baseline.

Discussion: The proposed investigation may demonstrate that propofol has an effect on the internal anal sphincter pressure which may affect its utility as an anesthetic for anorectal manometry.


Condition or disease Intervention/treatment
Chronic Constipation Drug: Propofol

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Study Type : Observational
Actual Enrollment : 20 participants
Observational Model: Case-Only
Time Perspective: Prospective
Study Start Date : October 2012
Actual Primary Completion Date : June 2013
Actual Study Completion Date : June 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Constipation
Drug Information available for: Propofol

Group/Cohort Intervention/treatment
Propofol
Chronically constipated children ages 2-6 years who will receive anesthesia for anorectal manometry including propofol per standard of care
Drug: Propofol



Primary Outcome Measures :
  1. Change in internal anal sphincter pressure from baseline [ Time Frame: Patients will be followed for the duration of outpatient anal rectal manometry procedure, an average of 10 minutes ]
    Baseline internal anal sphincter pressures will be measured at start of anorectal manometry. Patients will be followed for the duration of the procedure (~10 minutes). After propofol is given at end of procedure, changes to baseline internal anal sphincter pressure will be measured until return to baseline (up to 5 minutes)

  2. Time for internal anal sphincter pressure to return to baseline [ Time Frame: Patients will be followed for the duration of outpatient anal rectal manometry procedure, an average of 10 minutes ]
    Patients will be followed for the duration of the procedure (~10 minutes). After propofol is given at end of procedure, changes to baseline internal anal sphincter pressure will be measured until return to baseline (up to 5 minutes)



Information from the National Library of Medicine

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Ages Eligible for Study:   2 Years to 6 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Chronically constipated children ages 2-6 years who will receive anesthesia for anorectal manometry including propofol per standard of care
Criteria

Inclusion Criteria:

  • Ages 2 - 6 years
  • Chronic constipation
  • Requires anorectal manometry

Exclusion Criteria:

  • Ages 0-2 or > 6 years
  • Abnormal anorectal anatomy
  • Known history of Hirschsprung's Disease

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01793753


Locations
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United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Massachusetts General Hospital
Investigators
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Principal Investigator: Jaime Belkind-Gerson, MD MGH

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Jaime Belkind-Gerson, MD, Medical Director, Neurogastroenterology, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT01793753    
Other Study ID Numbers: 2012P000231
First Posted: February 18, 2013    Key Record Dates
Last Update Posted: September 14, 2016
Last Verified: September 2016
Additional relevant MeSH terms:
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Constipation
Signs and Symptoms, Digestive
Signs and Symptoms
Propofol
Hypnotics and Sedatives
Central Nervous System Depressants
Physiological Effects of Drugs
Anesthetics, Intravenous
Anesthetics, General
Anesthetics