Risk factors for postoperative ileus

Abstract

PurposeThis study aimed to examine extended postoperative ileus and its risk factors in patients who have undergone abdominal surgery, and discuss the techniques of prevention and management thereof the light of related risk factors connected with our study.MethodsThis prospective study involved 103 patients who had undergone abdominal surgery. The effects of age, gender, diagnosis, surgical operation conducted, excessive small intestine manipulation, opioid analgesic usage time, and systemic inflammation on the time required for the restoration of intestinal motility were investigated. The parameters were investigated prospectively.ResultsRegarding the factors that affected the restoration of gastrointestinal motility, resection operation type, longer operation period, longer opioid analgesics use period, longer nasogastric catheter use period, and the presence of systemic inflammation were shown to retard bowel motility for 3 days or more.ConclusionOur study confirmed that unnecessary analgesics use in patients with pain tolerance with non-steroid anti-inflammatory drugs, excessive small bowel manipulation, prolonged nasogastric catheter use have a direct negative effect on gastrointestinal motility. Considering that an exact treatment for postoperative ileus has not yet been established, and in light of the risk factors mentioned above, we regard that prevention of postoperative ileus is the most effective way of coping with intestinal dysmotility.

Randomized trial of subfascial infusion of ropivacaine for early recovery in laparoscopic colorectal cancer surgery

“…Postoperative ileus delays postoperative recovery, patient discomfort, and hospital discharge. Recovery of bowel function after surgery can be affected by several factors, such as hypoalbuminemia, narcotics, nasogastric tube, and bowel manipulation during surgery [282930]. In Moore et al's study [19], they compared ropivacaine wound infusion with placebo and despite less consumption of morphine in ropivacaine infusion group, the bowel recovery was not different between the groups.…”

Impact of postsurgical opioid use and ileus on economic outcomes in gastrointestinal surgeries

“…Median total hospital cost for the overall study population was significantly higher in patients with ileus versus no ileus ($21,046 [14,176] vs. $10,945 [7489-16,682]; p50.0001). Total cost per surgical procedure is depicted in Figure 2.…”

“…A 2012 survey of pharmacists identified GI complications as the most commonly reported complication of opioid pain management 13 . Opioids are associated with POI 1,3,4,10,14 and the dose of morphine required for effective analgesia is in excess of that which causes POI 1,15 . Activation of receptors in the GI tract is responsible for inhibition of gut motility whereas the receptors in the central nervous system mediate analgesia 3,16 .…”

“…Activation of receptors in the GI tract is responsible for inhibition of gut motility whereas the receptors in the central nervous system mediate analgesia 3,16 . Return of GI function appears to be related to opioid dosage, duration, and route of administration and extent of small intestine, stomach and colon involvement 4,6,10,14 . Approximately 22 million inpatient surgical procedures are performed annually in the United States, and an estimated 2.7 million of these procedures lead to POI lasting multiple days 8,9 .…”

Perbandingan Pemulihan Bising Usus pada Pasien Pascaoperasi Histerektomi per Laparotomi Menggunakan Analgetik Kombinasi Ketamin-Morfin dengan Morfin Intravena

“…19 Penelitian ini dilakukan pada satu jenis operasi, yaitu histerektomi dengan asumsi manipulasi usus yang sama dan lama operasi yang sama, dengan demikian kedua kelompok tersebut homogen dan layak untuk dibandingkan.…”