Postoperative ileus—an update on preventive techniques
- 12 August 2008
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Clinical Practice Gastroenterology & Hepatology
- Vol. 5 (10), 552-558
- https://doi.org/10.1038/ncpgasthep1230
Abstract
This article reviews techniques currently used to prevent or reduce the duration of postoperative ileus (POI), which is considered an undesirable stress response to major abdominal surgery that leads to discomfort, morbidity and prolonged hospital stay. In several randomized studies, a number of techniques have been demonstrated to reduce the occurrence and/or duration of POI: thoracic epidural analgesia with local anesthetics, peripheral opioid antagonists, laxatives, chewing gum, intravenous and incisional local anesthetics, and avoidance of routine nasogastric intubation and fluid excess. Early institution of oral feeding and laparoscopic surgery might also be effective, but there is less clear evidence available to support their use. When some of these techniques are combined as part of the concept of multimodal postoperative rehabilitation (fast-track surgery), the duration of POI after open or laparoscopic abdominal surgery can be reduced to 24-48 h in most patients. There is a need for data on the effect of these techniques on POI when applied to major upper abdominal surgeries and emergency abdominal operations (e.g. trauma, peritonitis, etc.).Keywords
This publication has 45 references indexed in Scilit:
- Fast-track colorectal surgeryThe Lancet, 2008
- Systemic Lidocaine Shortens Length of Hospital Stay After Colorectal SurgeryAnnals of Surgery, 2007
- Patterns of Gastrointestinal Recovery after Bowel Resection and Total Abdominal Hysterectomy: Pooled Results from the Placebo Arms of Alvimopan Phase III North American Clinical TrialsJournal of the American College of Surgeons, 2007
- Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized studyAmerican Journal of Obstetrics and Gynecology, 2007
- Alvimopan, for Postoperative Ileus Following Bowel ResectionAnnals of Surgery, 2007
- Fluid Therapy and Surgical Outcomes in Elective Surgery: A Need for Reassessment in Fast-Track SurgeryJournal of the American College of Surgeons, 2006
- Effects of Nonsteroidal Antiinflammatory Drugs on Patient-controlled Analgesia Morphine Side EffectsAnesthesiology, 2005
- Gastrointestinal transit after laparoscopic versus open colonic resectionSurgical Endoscopy, 2003
- Opioid-Induced Bowel DysfunctionDrugs, 2003
- Postoperative IleusDrugs, 2002