JaLCDOI 10.18926/AMO/32867
フルテキストURL fulltext.pdf
著者 Furusawa, Kazunari| Sugiyama, Hiroyuki| Ikeda, Atsushi| Tokuhiro, Akihiro| Koyoshi, Hiroko| Takahashi, Masanori| Tajima, Fumihiro|
抄録 The purpose of the present study was to investigate the relationship between bowel maneuvers and autonomic dysreflexia (AD) in patients with cervical spinal cord injuries (CSCI). Fifteen consecutive, clinically stable patients with CSCI participated. We evaluated changes in blood pressure (BP), pulse rate (PR) and classic symptoms of AD before, during and after a bowel program involving the manual removal of stool in lateral recumbency. The insertion of rectal medication induced a significant increase in systolic BP, which persisted during additional digital rectal stimulation. Furthermore, the manual removal of stool induced AD, with maximal increases of systolic BP (169.1(+-)19.5 mmHg, mean(+-)SD). However, the insertion of a finger into the anus after the end of stool flow did not cause a further increase in systolic BP. Systolic BP recovered to pre-program values within 5 min after defecation. Our study demonstrated that the combined effects of rectal and/or anal sphincter distension and uninhibited rectal contraction in response to the manual removal of stool might induce AD. We recommend avoiding, if at all possible, the manual removal of stool in order to prevent AD in patients with CSCI.
キーワード spinal cord injury autonomic dysrefl exia blood pressure bowel program
Amo Type Original Article
発行日 2007-08
出版物タイトル Acta Medica Okayama
61巻
4号
出版者 Okayama University Medical School
開始ページ 221
終了ページ 227
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 17726511
Web of Sience KeyUT 000248957100006