Key result
Peripherally acting mu opioid receptor antagonists improve postoperative ileus management alongside traditional approaches.
Peripherally acting mu opioid receptor antagonists such as methylnaltrexone and alvimopan are beneficial for managing postoperative ileus alongside traditional multi-modal approaches.
May support adjunctive ileus management; leaves open validation in prospective orthopedic trials.
Postoperative ileus, a temporary cessation in bowel motility, is a common and significant complication of major surgery. Consequences of postoperative ileus include increased patient discomfort, delayed time to adequate nutrition, prolonged length of stay, and increased cost to the patient and healthcare system. The traditional, multi-modal approach to the resolution of postoperative ileus includes opioid minimization, early ambulation, and early feeding. Newer medications, such as methlynaltrexone and alvimopan (which are peripherally acting mu opioid receptor antagonists), have become available and have proven beneficial for use with postoperative ileus.
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Barbara Magnuson (2012) conducted a review in Postoperative ileus. Management strategies (traditional multi-modal approach, methylnaltrexone, alvimopan) was evaluated. Newer peripherally acting mu opioid receptor antagonists, such as methylnaltrexone and alvimopan, have proven beneficial for the management of postoperative ileus alongside traditional approaches.
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