PubMed Health⌕ Search

PubMed · 15616078

Postoperative gastrointestinal tract dysfunction.

Abstract

Postoperative gastrointestinal (GI) tract dysfunction (PGID) is common and is associated with increased patient suffering and cost of care. The pathogenesis of PGID is complex and multifactorial. Traditional measures intended to reduce the incidence of PGID, such as the use of prokinetic drugs, nasogastric tube drainage, and the avoidance of early fluid and/or food intake, are apparently not beneficial. The administration of larger volumes of IV fluids to achieve predetermined increases in cardiac output has been shown in randomized trials to improve gut perfusion and reduce the incidence of PGID. A multimodal approach that includes limited surgical incision, regional local anesthesia, early mobilization, and enteral feeding has been associated with a dramatic reduction in postoperative complications, PGID, and length of hospital stay. However, none of these approaches has been validated in adequately powered multicenter prospective randomized controlled trials.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Michael G Mythen. 2005. Postoperative gastrointestinal tract dysfunction.. https://doi.org/10.1213/01.ane.0000139376.45591.17

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Learning under anesthesia: checking the light in the fridge? Commentary on Deeprose and Andrade (2006).

Research on learning under anesthesia has focused on showing that learning is possible in the absence of awareness. However, a simple dissociation between learning and awareness is conclusive only under strong additional assumptions, and the actual state of consciousness of an anesthetized person is difficult to determine. Instead of trying to establish complete unconsciousness, one might employ gradual anesthesia to experimentally vary the level of consciousness in a controlled fashion, checking whether cognitive processes exist that can change in opposite direction to measures of awareness.

Anesthesia↗

Vasoconstrictor prostanoids may be involved in reduced coronary reactive hyperemia after ischemia-reperfusion in anesthetized goats.

To examine coronary vasodilator reserve after ischemia-reperfusion, reactive hyperemia was determined during reperfusion after partial and total, brief and prolonged ischemia. To this, left circumflex coronary artery flow was electromagnetically measured, and partial (60 min) or total (15 and 60 min) occlusions of this artery were induced, followed in each case by 60-min reperfusion in anesthetized goats untreated and treated with N(W)-nitro-l-arginine methyl ester (l-NAME) or meclofenamate. In untreated and treated animals, coronary flow was decreased during reperfusion after the three types of ischemia. In hyperemic responses to 5- and 10-s coronary occlusions, repayment of debt decreased during reperfusion after the three types of ischemia in untreated animals, and this decrease was not affected by l-NAME. This decrease during reperfusion after partial and total, 60-min ischemia, but not after total, 15-min ischemia, reversed with meclofenamate. Peak hyperemic flow/control flow ratio decreased only during reperfusion after total 60-min occlusion in untreated animals and it was normalized by meclofenamate. These results show that ischemia-reperfusion reduces hyperemic response (vasodilator reserve); this diminution being dependent on duration and severity of ischemia. The hyperemic responses reduction during reperfusion after prolonged ischemia, but not after brief ischemia may be related at least in part to increased production of vasoconstrictor prostanoids.

Anesthesia↗