Effects of μ- and κ-opioid receptors on postoperative ileus in rats

Winter, Benedicte Y. De; Boeckxstaens, Guy E.; Man, Joris G. De; Moreels, Tom G.; Herman, Arnold G.; Pelckmans, P.A.

doi:10.1016/s0014-2999(97)01345-9

Cited by 50 publications

(37 citation statements)

References 19 publications

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“…De Winter ( 2003) also demonstrated that blockade of the afferent limb of the reflex pathway by peripheral κ -opioid agonists ameliorated postoperative ileus. In animal studies, bowel motility was normalized with use of fedotozine (selective κ -opioid receptor agonist) (De Winter et al, 1997;Friese et al, 1997;Riviere et al, 1994). These results support a role for peripheral κ -opioid receptors in the pathogenesis of postoperative ileus induced by abdominal surgery.…”

Section: Disscusionmentioning

confidence: 99%

Postoperative Ileus: Pathophysiology and Treatment

Tropskaya¹,

Попова²

2012

Current Concepts in Colonic Disorders

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Section: Disscusionmentioning

confidence: 99%

Postoperative Ileus: Pathophysiology and Treatment

Tropskaya¹,

Попова²

2012

Current Concepts in Colonic Disorders

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“…Kappa receptor agonists, rather than opioid antagonists, are being tested as treatment for postoperative ileus [71][72][73] . One cause of postoperative ileus is proposed to be the activation of an inhibitory nervous refl ex pathway [72] .…”

Section: Postoperative Ileusmentioning

confidence: 99%

“…One cause of postoperative ileus is proposed to be the activation of an inhibitory nervous refl ex pathway [72] . Kappa agonists increase the threshold of activation of the afferent limb of the inhibitory refl ex [74] and could thereby prevent reduction of bowel movements.…”

Section: Postoperative Ileusmentioning

confidence: 99%

Opioid-Induced Gastrointestinal Dysfunction

Mehendale¹,

Yuan²

2006

Dig Dis

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Use of opioid analgesics is associated with a number of side effects, especially opioid-induced gastrointestinal dysfunction. The extensive use of these compounds and the significant negative impact of the resulting gastrointestinal dysfunction on patients’ quality of life make it an important clinical issue. In recent years our understanding of the mechanisms of opioid-induced gastrointestinal dysfunction has advanced greatly. This article reviews the underlying pathophysiological mechanisms of specific gastrointestinal adverse effects of opioids. The role of endogenous opioid peptides in certain gastrointestinal diseases is also discussed. A better understanding of the pathophysiological mechanisms of opioid-induced bowel dysfunction should lead to the development of newer opioid analgesics and improved regimens resulting in reduced gastrointestinal adverse effects.

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“…Animal experiments have shown that an opioid antagonist such as naloxone reverses the morphine-induced decline in intestinal motility, 5 and clinical experiments have also documented that intravenous or subcutaneous injection of naloxone can antagonize opioid-related intestinal hypomotility. 6,7 The effect of epidural naloxone on human intestinal hypomotility has not been studied.…”

Section: Conclusion: Epidural Naloxone Reduces Epidural Morphine-indumentioning

confidence: 99%

Epidural naloxone reduces intestinal hypomotility but not analgesia of epidural morphine

Lee¹,

Shim²,

Choi³

et al. 2001

Can J Anesth/J Can Anesth

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Purpose: Epidural morphine is associated with decreased bowel motility and increased transit time. Low doses of intravenous naloxone reduce morphine-induced pruritus without reversing analgesia, but the effect of epidural naloxone on bowel motility has not been studied. Therefore we evaluated bowel motility and analgesia when naloxone was co-administered with morphine into the epidural space.Methods: Forty-three patients having combined thoracic epidural and general anesthesia for subtotal gastrectomy were randomly assigned to one of two study groups. All received a bolus dose of 3 mg epidural morphine at the beginning of surgery, followed by a continuous epidural infusion containing 3 mg morphine in 100 ml bupivacaine 0.125% with either no naloxone (control group, n=18) or a calculated dose of 0.208 µg·kg -1 ·hr -1 of naloxone (experimental group, n=25) for 48 hr. We measured the time to the first postoperative passage of flatus and feces to evaluate the restoration of bowel function, and visual analog scales (VAS) for pain during rest and movement. Scores were assessed at 2, 4, 8, 16, 24, 36 and 48 hr postoperatively.Results: The experimental group had a shorter time to the first postoperative passage of flatus (51.9 ± 16.6 hr vs 87.0 ± 19.5 hr, P < 0.001) and feces (95.3 ± 25.0 hr vs 132.9 ± 29.4 hr, P < 0.001). No differences were found in either resting or active VAS between the two groups.Conclusion: Epidural naloxone reduces epidural morphine-induced intestinal hypomotility without reversing its analgesic effects.Objectif : L'administration péridurale de morphine est associée à une baisse de la motilité intestinale et à une augmentation de la durée du transit. De faibles doses de naloxone intraveineuse réduisent le prurit induit par la morphine sans renverser l'analgésie, mais l'effet de l'administration péridurale de naloxone sur la motilité intestinale n'a pas encore été étudié. C'est pourquoi nous avons évalué cette action et l'analgésie de la naloxone administrée avec de la morphine dans l'espace péridural.Méthode : Quarante-trois patients qui recevaient une anesthésie péridurale thoracique et générale combinée, pour une gastrectomie partielle, ont été répartis au hasard en deux groupes. Tous ont reçu un bolus de 3 mg de morphine péridurale au début de l'intervention, suivi d'une perfusion péridurale continue de 3 mg de morphine dans 100 ml de bupivacaïne à 0,125 % sans naloxone (groupe témoin, n=18) ou avec une dose calculée de 0,208 µg·kg -1 ·h -1 de naloxone (groupe expérimental, n=25) pendant 48 h. Nous avons mesuré le temps écoulé avant la première expulsion des gaz intestinaux et des selles afin d'évaluer la restauration de la fonction intestinale et mesuré les scores de douleur à l'aide de l'échelle visuelle analogique (EVA), au repos et pendant le mouvement. Les scores postopératoires ont été relevés à 2, 4, 8, 16, 24, 36 et à 48 h.Résultats : Dans le groupe expérimental, le temps précédant le premier passage postopératoire des gaz (51,9 ± 16,6 h vs 87,0 ± 19,5 h, P < 0,001) et des selles (95,...

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Effects of μ- and κ-opioid receptors on postoperative ileus in rats

Cited by 50 publications

References 19 publications

Postoperative Ileus: Pathophysiology and Treatment

Postoperative Ileus: Pathophysiology and Treatment

Opioid-Induced Gastrointestinal Dysfunction

Epidural naloxone reduces intestinal hypomotility but not analgesia of epidural morphine

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