GASTROENTEROLOGY ARTICLE OF THE WEEK
February 19, 2009
Kehlet H. Postopeative ileus – An update on preventive techniques. Nat Clin Pract Gastroenterol Hepatol 2008;552-557
1. Which of the following interventions are or may be effective in decreasing POI
a. Nasogastric intubation
b. Metoclopramide
c. Chewing gum
d. Laparoscopy vs open surgery
e. Minimizing perioperative fluids, particularly NaCl
f. Early mobilization
2. Medications that have been shown effective as prophylaxis against postoperative nausea and vomiting include
a. phenothiazines
b. Benadryl
c. 5-HT receptor antagonists
d. droperidol
e. glucocorticoids
True of False
3. The incidence of POI is the same whether general or epidural anesthesia is used
4. Opioid analgesia is likely to prolong POI
5. Alvimopan, a mu-opoid receptor antagonist reduces duration of POI by about 16-18 hours after major intraabdominal surgery.
6. Avoidance of
NG tubes, earlier feedings and epidural anesthesia rather than systemic opiod
analgesia may be more effective than alvimopan