Efficacy and safety of low‐dose celecoxib in reducing post‐operative paralytic ileus after major abdominal surgery

Raju, Devinder; Hakendorf, Paul; Costa, Marcello; Wattchow, David

doi:10.1111/ans.12475

Cited by 13 publications

(15 citation statements)

References 23 publications

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“…The sympathetic neural response to intrusion of the peritoneal cavity and handling of bowel causes a reactive hypomotility of the GIT, which usually fades quickly upon abdominal closure, but prolonged ileus can occur, has been shown to be associated with increased IL‐6 and leucocyte infiltration of the bowel , and has a positive correlation with rates of AL . Here again evidence shows that inhibiting the inflammatory axis via COX‐2 improves ileus . Some clinical studies comparing laparoscopic with open surgery suggest a relationship between decreased inflammation, as evidenced by a lower CRP level postlaparoscopy, with lower ileus and AL rates , but caution needs to be exercised in interpreting these results as correlation does not always imply causation.…”

Section: The Role Of Inflammationmentioning

confidence: 99%

The triune of intestinal microbiome, genetics and inflammatory status and its impact on the healing of lower gastrointestinal anastomoses

2017

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Gastrointestinal resections are a common operation and most involve an anastomosis to rejoin the ends of the remaining bowel to restore gastrointestinal (GIT) continuity. While most joins heal uneventfully, in up to 26% of patients healing fails and an anastomotic leak (AL) develops. Despite advances in surgical technology and techniques, the rate of anastomotic leaks has not decreased over the last few decades raising the possibility that perhaps we do not yet fully understand the phenomenon of AL and are thus ill‐equipped to prevent it. As in all complex conditions, it is necessary to isolate each different aspect of disease for interrogation of its specific role, but, as we hope to demonstrate in this article, it is a dangerous oversimplification to consider any single aspect as the full answer to the problem. Instead, consideration of important individual observations in parallel could illuminate the way forward towards a possibly simple solution amidst the complexity. This article details three aspects that we believe intertwine, and therefore should be considered together in wound healing within the GIT during postsurgical recovery: the microbiome, the host genetic make‐up and their relationship to the perioperative inflammatory status. Each of these, alone or in combination, has been linked with various states of health and disease, and in combining these three aspects in the case of postoperative recovery from bowel resection, we may be nearer an answer to preventing anastomotic leaks than might have been thought just a few years ago.

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Section: The Role Of Inflammationmentioning

confidence: 99%

The triune of intestinal microbiome, genetics and inflammatory status and its impact on the healing of lower gastrointestinal anastomoses

2017

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“…Studies examining opioid-sparing analgesic regimens have shown a decrease in postoperative ileus. Lidocaine, 2 celecoxib, 3 magnesium, 4 and epidural analgesia 5 have all been shown to decrease opioid consumption and decrease risk of postoperative ileus formation. Postoperative ileus contributes significantly to both cost and LOS in patients undergoing colorectal surgery.…”

mentioning

confidence: 99%

Pain Management in Enhanced Recovery after Surgery (ERAS) Protocols

Simpson

Bao

Agarwala

2019

Clinics in Colon and Rectal Surgery

160

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Pain control is an integral part of Enhanced Recovery after Surgery (ERAS) protocols for colorectal surgery. While opioid therapy remains the mainstay of therapy for postsurgical pain, opioids have undesired side effects including delayed recovery of bowel function, respiratory depression, and postoperative nausea and vomiting. A variety of nonopioid systemic medical therapies as well as regional and neuraxial techniques have been described as improving pain control while reducing opioid use. Multimodal and preemptive analgesia as part of an ERAS protocol facilitates early mobility and early return of bowel function and decreases postoperative morbidity. In this review, we examine several multimodal therapies and their impact on postoperative analgesia, opioid use, and recovery for patients undergoing colorectal surgery.

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“…Holte and colleagues 31 showed in a retrospective study that celecoxib was an independent predictor of anastomotic leaks in patients who had colonic surgery. On the contrary, Gorissen and colleagues 67 and Raju and colleagues 33 could not demonstrate the association. 31 33 67 In fact, the authors indicated that the risk of anastomotic leaks was higher after the use of non-selective NSAIDs than with coxibs.…”

Section: Perioperative Nsaids and Anastomostic Leaksmentioning

confidence: 86%

Non-steroidal anti-inflammatory drugs in the oncological surgical population: beneficial or harmful? A systematic review of the literature

Cata

Guerra

Chang

et al. 2017

British Journal of Anaesthesia

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The literature is not conclusive on whether the use of NSAIDs is associated with anastomotic leaks after gastrointestinal cancer surgery. Also, the current evidence is equivocal regarding the effects of short-term NSAIDs on cancer recurrence after major cancer surgery. Three RCTs are being conducted to assess the impact of NSAIDs on cancer recurrence. There are no registered RCTs that are testing the hypothesis of whether the perioperative use of NSAIDs increases the rate of anastomotic leaks.

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Efficacy and safety of low‐dose celecoxib in reducing post‐operative paralytic ileus after major abdominal surgery

Abstract: The use of low-dose COX-2 inhibitor over a short period of time decreases the paralytic ileus rates and does not cause any significant morbidity.

Cited by 13 publications

References 23 publications

The triune of intestinal microbiome, genetics and inflammatory status and its impact on the healing of lower gastrointestinal anastomoses

The triune of intestinal microbiome, genetics and inflammatory status and its impact on the healing of lower gastrointestinal anastomoses

Pain Management in Enhanced Recovery after Surgery (ERAS) Protocols

Non-steroidal anti-inflammatory drugs in the oncological surgical population: beneficial or harmful? A systematic review of the literature

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