Comparação da insuflação sustentada do balão intra-retal com insuflação e desinsuflação rápidas em indivíduo assintomáticos

• Autor(a) principal: Monteiro, Fernando José do Rêgo
• Data de Publicação: 2006
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/7317
• topic: Manometria; Defecação; Canal Anal

Anorectal manometry is limited mainly by the lack of standardized parameters and techniques. A number of different techniques have been used to induce the anorectal inhibition reflex (AIR), but results have been inconsistent. The objective of the present study was to identify differences in AIR parameters between two different manometry techniques: a) rapid inflation (30ml/s) of intrarectal balloon with 30 and 60 ml air, maintained during 60 seconds and followed by rapid deflation, and b) fast inflation and deflation under similar circumstances. The study included 40 healthy volunteers aged 20-40 years and used a 4-channel pneumohydraulic perfusion system and radial catheter. The parameters, which were measured at approximately 2 cm from the anal margin by the stationary pull-through method, included: length of functional anal canal, high-pressure zone (HPZ) and highest pressure point in relation to anal margin, minimum rectal sensitivity, initial voiding urgency sensitivity, average basal anal pressure, maximum voluntary contraction pressure, response to voiding contraction and AIR-related parameters. The length of the functional anal canal was found to be significantly increased in males, but no significant difference in HPZ was observed between the sexes. On the average, the highest pressure was located 1.7cm (1-2 cm) from the anal margin. No significant difference was found between the sexes with regard to pre-reflex minimum rectal sensitivity, initial voiding urgency sensitivity and average basal anal pressure. The maximum voluntary contraction pressure was significantly increased in males. A normal response of internal anal sphincter (IAS) relaxation to voiding contraction was observed in 90.9% of the subjects while unsynergistic voiding patterns were found in 9.09%. Rapid inflation maintained for 60 seconds significantly increased the maximum IAS relaxation time, the recovery time of the IAS tone and the duration of the reflex, but did not affect the amplitude of the maximum IAS relaxation compared to rapid inflation and deflation. Our findings indicate that AIR parameters depend on inflation technique and that results from different centers will only be comparable after techniques have been stadardized.