Effect of Caffeine Intake on Postoperative Ileus: A Systematic Review and Meta-Analysis

Gkegkes, Ioannis D.; Minis, Evelyn; Iavazzo, Christos

doi:10.1159/000496431

Cited by 35 publications

(43 citation statements)

References 38 publications

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“…Gastrointestinal dysmotility is a common problem in the intensive care patients, compounded by opiates, surgery, sepsis and electrolyte abnormalities 53 . Caffeine has been shown to effectively improve gastrointestinal motility with no signi cant side effect 54 . Caffeine intake has been historically limited in peri-operatively in patients due to the risk of vasospasm and risk of cardiac events 55,56 .…”

Section: Discussionmentioning

confidence: 99%

Use of Therapeutic Caffeine in Acute Care Post-operative and Critical Care Settings: a Scoping Review

Bright¹,

Raman

Laupland

2020

Preprint

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BackgroundCaffeine is the most utilised psychoactive drug worldwide. However, caffeine withdrawal and the therapeutic use of caffeine in intensive care and in the peri-operative period have not been well summarised. Our objective was to conduct a scoping review of caffeine withdrawal and use in the intensive care unit (ICU) and post-operative patients. MethodsPubMed, Embase, CINAHL Complete, Scopus and Web of Science were systematically searched for studies investigating the effects of caffeine withdrawal or administration in ICU patients and in the peri-operative period. Areas of recent systematic review such as pain or post-dural puncture headache were not included in this review. Studies were limited to adults. ResultsOf 2268 articles screened, 26 were included and grouped into two themes of caffeine use in in the peri-operative period and in the ICU. Caffeine withdrawal in the post-operative period increases the incidence of headache, which can be effectively treated prophylactically with peri-operative caffeine. There were no studies investigating caffeine withdrawal or effect on sleep wake cycles, daytime somnolence, or delirium in the intensive care setting. Administration of caffeine results in faster emergence from sedation and anaesthesia, particularly in individuals who are at high risk of post-extubation complications. There has only been one study investigating caffeine administration to facilitate post-anaesthetic emergence in ICU. Caffeine administration appears to be safe in moderate doses in the peri-operative period and in the intensive care setting. ConclusionsAlthough caffeine is widely used, there is a paucity of studies investigating withdrawal or therapeutic effects in patients admitted to ICU and further novel studies are a priority.

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Section: Discussionmentioning

confidence: 99%

Use of Therapeutic Caffeine in Acute Care Post-operative and Critical Care Settings: a Scoping Review

Bright¹,

Raman

Laupland

2020

Preprint

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“…We have read with great interest the paper "Effect of Caffeine Intake on Postoperative Ileus: A Systematic Review and Meta-Analysis and Muscle Breakdowns" by Gkegkes et al [1], and we found his manuscript of importance with a view to clinical prevention. The paper reviewed the available evidence concerning the postoperative administration of coffee in enhanced recovery in the postoperative period.…”

Section: Dear Editormentioning

confidence: 94%

“…Gkegkes et al [1] referred that pathophysiology concerning postoperative ileus is poorly defined and dependent on a multitude of factors; the most important of which are inflammation, the effects of surgical manipulation, administration of opioids, autonomic dysfunction, and deregulation of the gastrointestinal hormone activity and electrolyte fluctuations. Caffeine acts positively on inflammation and promotes nitric oxide synthesis in the endothelium by the release of Ca2 from the endoplasmic reticulum through activation of the ryanodinesensitive Ca2 channel and the suppression of cyclic guanosine monophosphate degradation in the isolated rat aorta, resulting in the caffeine-induced augmentation of endothelium-dependent vasodilatation.…”

Section: Dear Editormentioning

confidence: 99%

“…Nonhabitual coffee consumers do not develop tolerance thereby typically experiencing the compound's effects at lower levels of dietary intake when consumed. Clinically, the postoperative administration of coffee reduces time to first bowel movement [1,4,7]. This has important clinical and economic consequences in major abdominal surgery [7].…”

Section: Dear Editormentioning

confidence: 99%

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Effects of Caffeine on Colon: A Potential Clinical Use of Coffee in Surgical Patients

et al. 2019

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“…In this study, NOM presented a success rate of 72.7% within ve years. (13) Additionally, several systematic reviews have reported clinical bene ts of NOM versus surgical approach (1,6,(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Nonoperative Management Versus Open and Laparoscopic Surgery for Uncomplicated Acute Appendicitis in Colombia.

Guevara-Cuéllar

Rengifo-Mosquera

Parody-Rúa³

2021

Preprint

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BackgroundTraditionally, uncomplicated acute appendicitis (AA) has been treated with appendectomy. However, the surgical alternatives might carry out significant complications, impaired quality of life, and higher costs than nonoperative treatment. In consequence it is necessary to evaluate the efficiency of the different therapeutic alternatives in patients diagnosed with uncomplicated appendicitis. MethodsWe performed a model-based cost-effectiveness analysis comparing nonoperative management (NOM) with open appendectomy (OA) and laparoscopic appendectomy (LA) in patients otherwise healthy adults aged 18 years and older with a diagnosis of uncomplicated AA in the Colombian health system. The time horizon was five years. A discount rate of 5% was applied to both costs and outcomes. The health outcomes were quality-adjusted life years (QALYs). Costs were identified, quantified, and valorized from a payer perspective; therefore, only direct health costs were included. An incremental analysis was estimated to determine the incremental cost-effectiveness ratio (ICER). In addition, the net monetary benefit (NMB) was calculated for each alternative using a willingness to pay lower than a one gross domestic product. A deterministic and probabilistic sensitivity analysis was performed.ResultsLA presents a lower cost ($ 363±35) than OA ($ 384±41) and NOM ($392±44). NOM exhibited higher QALYs (3.3332±0.0276) in contrast with LA (3.3310± 0.057) and OA (3.3261±0.0707). LA dominated the OA. The ICER between LA and NOM was $24 000/QALY. LA has a 52% probability of generating the highest NMB versus its counterparts, followed by NOM (30%) and OA (18%). There is a probability of 0.69 that laparoscopy generates more significant benefit than medical management. The mean value of that incremental NMB would be $93.7 per patient.ConclusionsLA is more likely to produce more significant monetary benefits than NOM and OA in uncomplicated AA. This feature becomes the most efficient alternative as long as the conditions for its adequate performance exist. However, NOM may be a more acceptable alternative from the patient's perspective or when only the OA option is available.

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Effect of Caffeine Intake on Postoperative Ileus: A Systematic Review and Meta-Analysis

Cited by 35 publications

References 38 publications

Use of Therapeutic Caffeine in Acute Care Post-operative and Critical Care Settings: a Scoping Review

Use of Therapeutic Caffeine in Acute Care Post-operative and Critical Care Settings: a Scoping Review

Effects of Caffeine on Colon: A Potential Clinical Use of Coffee in Surgical Patients

Cost-Effectiveness Analysis of Nonoperative Management Versus Open and Laparoscopic Surgery for Uncomplicated Acute Appendicitis in Colombia.

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