Alvimopan, a perpherally acting mu-opioid receptor antagonist, compared with placebo in postoperative ileus after major abdominal surgery

Abstract

On page 65, in column 1 of the ''Patients and methods'' section, the wrong study number was published. The first sentence under the heading ''Study design and treatments'' should read:This was a randomized, double-blind, placebo-controlled, parallel-group, phase III trial (Study 14CL308) designed to evaluate the efficacy and safety of 6 and 12 mg alvimopan for the management of POI in patients undergoing BR or TAH.

Anesthetic Routines: The Anesthesiologist's Role in GI Recovery and Postoperative Ileus

“…Peripherally acting mu-opioid receptor antagonists, such as the FDA-approved alvimopan and investigational methylnaltrexone, do not appear to reverse central opioid action and may give anesthesiologists and surgeons the option of using preemptive opioid analgesics without substantial opioid-associated GI adverse effect [ 9 , 69 – 79 ]. Methylnaltrexone has been studied predominantly in patients with opioid-induced bowel dysfunction.…”

“…Alvimopan is an oral PAM-OR antagonist with low bioavailability (6%) that was approved by the FDA in 2008 for the management of POI [ 83 ]. Alvimopan accelerated time to GI recovery and time to hospital discharge order written compared with placebo in 4 North American phase III trials of POI in patients undergoing bowel resection via laparotomy receiving opioid-based IV-PCA [ 72 , 74 , 77 – 79 ]. In a fifth phase III trial that was conducted in Europe, the benefits of alvimopan were seen in a post hoc subgroup analysis of patients who received opioid-based IV-PCA for at least the first 48 hours after surgery [ 76 ].…”

Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial

“…Many pharmacologic agents have been evaluated for their effect on postoperative ileus. Apart from cisapride, which has been removed from the market, only alvimopan, a peripherally acting μ opioid antagonist, has shown an accelerated recovery time [15,16,21,22]. Neither metoclopramide nor erythromycin altered the course of postoperative ileus although they may have a role in the treatment of nausea or impaired stomach emptying due to pyloric spasm [12,13,17,18,34,35].…”

“…Several pharmacologic studies have been carried out to evaluate the effect of different agents, such as metoclopramide, erythromycin, tropisetron, alvimopan, neostigmine, and cisapride on postoperative ileus [11][12][13][14][15][16][17][18][19][20][21][22]. Only cisapride, which has been removed from the market for cardiac side effects, and alvimopan showed a significant acceleration of gastrointestinal recovery [15,16,22].…”

“…Only cisapride, which has been removed from the market for cardiac side effects, and alvimopan showed a significant acceleration of gastrointestinal recovery [15,16,22].…”