Ileus secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3]. | |||
==Secondary Prevention== | ==Secondary Prevention== | ||
*Effective measures for the secondary prevention of ileus include:<ref name="Lassen2009">{{cite journal|last1=Lassen|first1=Kristoffer|title=Consensus Review of Optimal Perioperative Care in Colorectal Surgery|journal=Archives of Surgery|volume=144|issue=10|year=2009|pages=961|issn=0004-0010|doi=10.1001/archsurg.2009.170}}</ref><ref name="Kehlet2008">{{cite journal|last1=Kehlet|first1=Henrik|title=Postoperative ileus—an update on preventive techniques|journal=Nature Clinical Practice Gastroenterology & Hepatology|volume=5|issue=10|year=2008|pages=552–558|issn=1743-4378|doi=10.1038/ncpgasthep1230}}</ref><ref name="Bundgaard-NielsenHolte2007">{{cite journal|last1=Bundgaard-Nielsen|first1=M.|last2=Holte|first2=K.|last3=Secher|first3=N. H.|last4=Kehlet|first4=H.|title=Monitoring of peri-operative fluid administration by individualized goal-directed therapy|journal=Acta Anaesthesiologica Scandinavica|volume=51|issue=3|year=2007|pages=331–340|issn=0001-5172|doi=10.1111/j.1399-6576.2006.01221.x}}</ref><ref name="PatelPanchagnula2012">{{cite journal|last1=Patel|first1=Santosh|last2=Panchagnula|first2=Umakanth|last3=Lutz|first3=JanM|last4=Bansal|first4=Sujesh|title=Anesthesia and perioperative management of colorectal surgical patients - A clinical review (Part 1)|journal=Journal of Anaesthesiology Clinical Pharmacology|volume=28|issue=2|year=2012|pages=162|issn=0970-9185|doi=10.4103/0970-9185.94831}}</ref><ref name="AdaminaKehlet2011">{{cite journal|last1=Adamina|first1=Michel|last2=Kehlet|first2=Henrik|last3=Tomlinson|first3=George A.|last4=Senagore|first4=Anthony J.|last5=Delaney|first5=Conor P.|title=Enhanced recovery pathways optimize health outcomes and resource utilization: A meta-analysis of randomized controlled trials in colorectal surgery|journal=Surgery|volume=149|issue=6|year=2011|pages=830–840|issn=00396060|doi=10.1016/j.surg.2010.11.003}}</ref> | |||
**Minimal invasive surgeries may prevent the severity of ileus seen in post-opertaive states. Surgical procedures done via laproscopy are associated with early return of GI function whereas laprotomy is associated with increased severity and incidence of paraltyic ileus. | |||
**The choice of anesthesia can also reduce the morbidity and mortality associated with surgeries. Local spinal anesthesia via epidural approach has been observed with increased colonic blood flow and early return of GI function. | |||
**Use of medications such as dexamethasone at induction, or a serotonin receptor antagonist at closure; general anesthesia with propofol and remifentanil along with prophylaxis can reduce symptoms of postoperative nausea and vomiting. | |||
*Removal of urinary within 24 to 48 hours of surgery and avoidance of nasogastric tubes and abdominal drains. | |||
*Early mobilization and ambulation | |||
*Use of NSAIDs (such as IV ketorolac) as a baseline analgesic with avoidance of opioid anesthesia and analgesia. | |||
*Recent studies have shown that chweing gum in the postoperative ileus increases activation of neural and hormonal mechanisms and GI motility. | |||
*Use of osmotic and stimulant laxatives (such as bisacodyl suppository)may also lead to early reversal of postoperative ileus. | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
Secondary Prevention
- Minimal invasive surgeries may prevent the severity of ileus seen in post-opertaive states. Surgical procedures done via laproscopy are associated with early return of GI function whereas laprotomy is associated with increased severity and incidence of paraltyic ileus.
- The choice of anesthesia can also reduce the morbidity and mortality associated with surgeries. Local spinal anesthesia via epidural approach has been observed with increased colonic blood flow and early return of GI function.
- Use of medications such as dexamethasone at induction, or a serotonin receptor antagonist at closure; general anesthesia with propofol and remifentanil along with prophylaxis can reduce symptoms of postoperative nausea and vomiting.
- Removal of urinary within 24 to 48 hours of surgery and avoidance of nasogastric tubes and abdominal drains.
- Early mobilization and ambulation
- Use of NSAIDs (such as IV ketorolac) as a baseline analgesic with avoidance of opioid anesthesia and analgesia.
- Recent studies have shown that chweing gum in the postoperative ileus increases activation of neural and hormonal mechanisms and GI motility.
- Use of osmotic and stimulant laxatives (such as bisacodyl suppository)may also lead to early reversal of postoperative ileus.
References
- ↑ Lassen, Kristoffer (2009). "Consensus Review of Optimal Perioperative Care in Colorectal Surgery". Archives of Surgery. 144 (10): 961. doi:10.1001/archsurg.2009.170. ISSN 0004-0010.
- ↑ Kehlet, Henrik (2008). "Postoperative ileus—an update on preventive techniques". Nature Clinical Practice Gastroenterology & Hepatology. 5 (10): 552–558. doi:10.1038/ncpgasthep1230. ISSN 1743-4378.
- ↑ Bundgaard-Nielsen, M.; Holte, K.; Secher, N. H.; Kehlet, H. (2007). "Monitoring of peri-operative fluid administration by individualized goal-directed therapy". Acta Anaesthesiologica Scandinavica. 51 (3): 331–340. doi:10.1111/j.1399-6576.2006.01221.x. ISSN 0001-5172.
- ↑ Patel, Santosh; Panchagnula, Umakanth; Lutz, JanM; Bansal, Sujesh (2012). "Anesthesia and perioperative management of colorectal surgical patients - A clinical review (Part 1)". Journal of Anaesthesiology Clinical Pharmacology. 28 (2): 162. doi:10.4103/0970-9185.94831. ISSN 0970-9185.
- ↑ Adamina, Michel; Kehlet, Henrik; Tomlinson, George A.; Senagore, Anthony J.; Delaney, Conor P. (2011). "Enhanced recovery pathways optimize health outcomes and resource utilization: A meta-analysis of randomized controlled trials in colorectal surgery". Surgery. 149 (6): 830–840. doi:10.1016/j.surg.2010.11.003. ISSN 0039-6060.