Selective Opioid Antagonists Following Bowel Resection for Prevention of Postoperative Ileus: a Systematic Review and Meta-analysis

McKechnie, Tyler; Anpalagan, Tharani; Ichhpuniani, Simarpreet; Lee, Yung; Ramji, Karim; Eskicioglu, Cagla

doi:10.1007/s11605-021-04973-8

Cited by 6 publications

(4 citation statements)

References 55 publications

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“…With postoperative coffee consumption, LOS was reduced by 1.5 days. Given that other consensus data show that ERPs reduce morbidity (RR 0.78) and LOS (−3.1 days) and opioid antagonists, which are frequently used to improve the postoperative course, reduce POI (32%) and LOS (−0.3 days) [34,35], the improved POI and LOS following coffee intake appear to be meaningful in the clinical setting.…”

Section: Discussionmentioning

confidence: 96%

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Effect of Postoperative Coffee Consumption on Postoperative Ileus after Abdominal Surgery: An Updated Systematic Review and Meta-Analysis

et al. 2021

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Background: Previous systematic reviews have not clarified the effect of postoperative coffee consumption on the incidence of postoperative ileus (POI) and the length of hospital stay (LOS). We aimed to assess its effect on these postoperative outcomes. Methods: Studies evaluating postoperative coffee consumption were searched using electronic databases until September 2021 to perform random-effect meta-analysis. The quality of evidence was assessed using the Cochrane risk-of-bias tool. Caffeinated and decaffeinated coffee were also compared. Results: Thirteen trials (1246 patients) and nine ongoing trials were included. Of the 13 trials, 6 were on colorectal surgery, 5 on caesarean section, and 2 on gynecological surgery. Coffee reduced the time to first defecation (mean difference (MD) −10.1 min; 95% confidence interval (CI) = −14.5 to −5.6), POI (risk ratio 0.42; 95% CI = 0.26 to 0.69); and LOS (MD −1.5; 95% CI = −2.7 to −0.3). This trend was similar in colorectal and gynecological surgeries. Coffee had no adverse effects. There was no difference in POI or LOS between caffeinated and decaffeinated coffee (p > 0.05). The certainty of evidence was low to moderate. Conclusion: This review showed that postoperative coffee consumption, regardless of caffeine content, likely reduces POI and LOS after colorectal and gynecological surgery.

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Section: Discussionmentioning

confidence: 96%

“…In the case of cesarean section, the impact of coffee on LOS after cesarean section may be small because the hospital stay is short to begin with [48,49]. In the case of colorectal surgery, coffee had a relatively weak effect on POI, which may be due to other factors related to POI, such as postoperative exercise and nutrition [35,50].…”

Section: Discussionmentioning

confidence: 99%

Effect of Postoperative Coffee Consumption on Postoperative Ileus after Abdominal Surgery: An Updated Systematic Review and Meta-Analysis

et al. 2021

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“…The peripherally-acting mu-opioid receptor antagonist (PAMORA) activity was restricted to the periphery. According to Tyler's meta-analysis, the use of selective opioid antagonists reduced the incidence of POI in patients undergoing bowel resection and minimized hospitalization expenditure for patients undergoing intestinal resection [ 118 ]. The drug used in the clinical trials in the included studies was alvimopan [ 94 ]; the total dosage of alvimopan was restricted to 15 doses, with instructions to take a 12-mg capsule 30 min to 5 h before surgery and a 12-mg capsule twice daily from the day of the operation until discharge [ 116 ], for up to seven days.…”

Section: Discussionmentioning

confidence: 99%

Effect evaluation of different preventive measures for ileus after abdominal operation: A systematic review and network meta-analysis

Cui,

Zhang,

Zhang

et al. 2024

Heliyon

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“…Postoperative ileus (POI) emerges as a prevalent problem after abdominal surgery, contributing to extended hospitalization, patient distress, and a considerable economic burden on patients due to escalated healthcare resource utilization and declining health status. [ 1 ] The frequency of POI in the initial week following surgery exhibits substantial variation, estimated to range from 3% to 50%, largely attributable to the dearth of consensus on defining abnormal recovery duration for intestinal motility. [ 2 ] Central characteristics of POI involve impaired bowel function and reduced motility, which can result in ineffective movement of intestinal contents.…”

Section: Introductionmentioning

confidence: 99%

An outline of the management and prevention of postoperative ileus: A review

Iskander

2024

Medicine

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Postoperative ileus (POI) is a prevalent surgical complication, which results in prolonged hospitalization, patient distress, and substantial economic burden. The literature aims to present a brief outline of interventions for preventing and treating POI post-surgery. Data from 2014 to 2023 were gathered from reputable sources like PubMed, PubMed Central, Google Scholar, Research Gate, and Science Direct. Inclusion criteria focused on studies exploring innovative treatments and prevention strategies for POI, using keywords such as novel POI treatments, non-pharmacological prevention, POI incidence rates, POI management, and risk factors. The findings revealed that integration of preventive measures such as coffee consumption, chewing gum, probiotics, and use of dikenchuto within enhanced recovery programs has significantly reduced both the frequency and duration of POI, without any adverse effects, with minimally invasive surgical approaches showing promise as an additional preventive strategy. While treatment options such as alvimopan, NSAIDs, and acupuncture have demonstrated efficacy, the use of lidocaine has raised concerns due to associated adverse effects. The ongoing exploration of novel therapeutic strategies such as targeting the mast cells, vagal nerve stimulation and tight junction protein, and prokinetic-mediated instigation of the cholinergic anti-inflammatory trail not only holds promise for enhanced treatment but also deepens the understanding of intricate cellular and molecular pathways underlying POI. POI presents a complex challenge in various surgical specialties, necessitating a multifaceted management approach. The integration of preventive and treatment measures within enhanced recovery programs has significantly reduced POI frequency and duration.

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Selective Opioid Antagonists Following Bowel Resection for Prevention of Postoperative Ileus: a Systematic Review and Meta-analysis

Cited by 6 publications

References 55 publications

Effect of Postoperative Coffee Consumption on Postoperative Ileus after Abdominal Surgery: An Updated Systematic Review and Meta-Analysis

Effect of Postoperative Coffee Consumption on Postoperative Ileus after Abdominal Surgery: An Updated Systematic Review and Meta-Analysis

Effect evaluation of different preventive measures for ileus after abdominal operation: A systematic review and network meta-analysis

An outline of the management and prevention of postoperative ileus: A review

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