Why the study?
Despite advances in peri-operative management, the rate of prolonged post-operative ileus remains high, leading to potentially serious consequences such as bronchial inhalation or acute functional renal failure.
This review outlines the pathophysiology of post-operative ileus and discusses current and potential pharmacological treatments.
POI rates remain high despite advances; leaves open need for targeted prevention trials.
Post-operative ileus (POI) is a frequent complication after abdominal surgery. The consequences of POI can be potentially serious such as bronchial inhalation or acute functional renal failure. Numerous advances in peri-operative management, particularly early rehabilitation, have made it possible to decrease POI. Despite this, the rate of prolonged POI ileus remains high and can be as high as 25% of patients in colorectal surgery. From a pathophysiological point of view, POI has two phases, an early neurological phase and a later inflammatory phase, to which we could add a “pharmacological” phase during which analgesic drugs, particularly opiates, play a central role. The aim of this review article is to describe the phases of the pathophysiology of POI, to analyse the pharmacological treatments currently available through published clinical trials and finally to discuss the different research areas for potential pharmacological targets.
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Buscail et al. (2021) studied this question.
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