Selective block of external anal sphincter activation during electrical stimulation of the sacral anterior roots in a canine model

Abstract

Our aim was to electrically activate small diameter parasympathetic fibres in the sacral anterior roots, without activating the larger somatic fibres to the external anal sphincter (EAS). Electrodes were implanted on selected roots in five adult dogs. Pressures were recorded from the rectum and EAS. Quasitrapezoidal (Qzt) pulses for selective activation of smaller axons and narrow rectangular (Rct) pulses to activate all fibres were applied. Sphincter block was defined as [(P(max) - P(min))/P(max)] x 100%. Roots were also tested with 20 Hz trains. In three animals, evacuation of bowel contents was recorded with artificial fecal material. Stimulation with Qzt pulses showed decrease in sphincter recruitment with increasing pulse amplitudes, indicating propagation arrest in the large fibres. The average sphincter suppression was 94.1% in 16 roots implanted. With Qzt pulse trains, the average evoked sphincter pressure was significantly lower than Rct pulses. Evoked rectal pressures were not significantly different. The mean mass of expelled bowel contents of 51.1 g by Qzt trains was significantly higher than that of 14.8 g expelled by Rct trains. Our results demonstrate that this selective stimuli can activate small diameter fibres innervating the distal bowel and result in significant evacuation of rectal contents.