Ileus primary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Effective measures for the primary prevention of ileus include | Effective measures for the [[primary prevention]] of ileus include early mobilization, avoidance of [[nasogastric tube|Ryle's tube]] ([[nasogastric tube]]), prior [[Mouth|oral]] [[feeding]] with high [[carbohydrate]] solid or liquid [[solution]], limiting [[parenteral]] [[fluid|fluids]], avoidance of [[pain]] [[medication|medications]] such as [[opiates]], utilizing a minimally [[Invasive (medical)|invasive]] [[surgery|surgical method]] and use of [[epidural anesthesia]] for post[[surgery|operative]] [[analgesia]]. | ||
==Primary Prevention== | ==Primary Prevention== | ||
Effective measures for the primary prevention of ileus include:<ref name="pmid9149181">{{cite journal |vauthors=Resnick J, Greenwald DA, Brandt LJ |title=Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART I |journal=Am. J. Gastroenterol. |volume=92 |issue=5 |pages=751–62 |year=1997 |pmid=9149181 |doi= |url=}}</ref><ref name="pmid9177505">{{cite journal |vauthors=Resnick J, Greenwald DA, Brandt LJ |title=Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART II |journal=Am. J. Gastroenterol. |volume=92 |issue=6 |pages=934–40 |year=1997 |pmid=9177505 |doi= |url=}}</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> | Effective measures for the [[Prevention (medical)|primary prevention]] of [[ileus]] include:<ref name="pmid9149181">{{cite journal |vauthors=Resnick J, Greenwald DA, Brandt LJ |title=Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART I |journal=Am. J. Gastroenterol. |volume=92 |issue=5 |pages=751–62 |year=1997 |pmid=9149181 |doi= |url=}}</ref><ref name="pmid9177505">{{cite journal |vauthors=Resnick J, Greenwald DA, Brandt LJ |title=Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART II |journal=Am. J. Gastroenterol. |volume=92 |issue=6 |pages=934–40 |year=1997 |pmid=9177505 |doi= |url=}}</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="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | ||
*Early mobilization | *Early mobilization | ||
*Avoid insertion of Ryle's tube (nasogastric tube) | *Avoid routine insertion of [[nasogastric tube|Ryle's tube]] ([[nasogastric tube]]) | ||
*Prior oral feeding with high carbohydrate solid or liquid solution (preferably | *Prior [[Mouth|oral]] [[feeding]] with high [[carbohydrate]] solid or liquid [[solution]] (preferably six hours prior to [[surgery]]) | ||
*Administration of clear fluids within 2-3 hours of surgery | *Administration of [[fluid|clear fluids]] within 2-3 hours of [[surgery]] | ||
*Limited parenteral fluids | *Limited [[parenteral]] [[fluid|fluids]] | ||
*Avoidance of pain medications such as opiates | *Utilizing a minimally [[Invasive (medical)|invasive]] [[surgery|surgical method]] if possible | ||
*Epidural catheter ( | *Avoidance of [[pain]] [[medications]] such as [[opiates]] | ||
*[[Epidural]] [[catheter]] ([[spinal anesthesia]]) for post[[surgery|operative]] [[analgesia]] | |||
*Post[[surgery|operative]] gum chewing, which may increases the [[intestine|intestinal]] [[peristalsis]] due to the cephalovagal [[reflex]] and [[inflammation]] (level Ia evidence) | |||
==References== | ==References== | ||
{{Reflist|2}} | |||
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[[Category:Medicine]] | |||
[[Category: | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
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Latest revision as of 19:30, 13 October 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
Effective measures for the primary prevention of ileus include early mobilization, avoidance of Ryle's tube (nasogastric tube), prior oral feeding with high carbohydrate solid or liquid solution, limiting parenteral fluids, avoidance of pain medications such as opiates, utilizing a minimally invasive surgical method and use of epidural anesthesia for postoperative analgesia.
Primary Prevention
Effective measures for the primary prevention of ileus include:[1][2][3][4]
- Early mobilization
- Avoid routine insertion of Ryle's tube (nasogastric tube)
- Prior oral feeding with high carbohydrate solid or liquid solution (preferably six hours prior to surgery)
- Administration of clear fluids within 2-3 hours of surgery
- Limited parenteral fluids
- Utilizing a minimally invasive surgical method if possible
- Avoidance of pain medications such as opiates
- Epidural catheter (spinal anesthesia) for postoperative analgesia
- Postoperative gum chewing, which may increases the intestinal peristalsis due to the cephalovagal reflex and inflammation (level Ia evidence)
References
- ↑ Resnick J, Greenwald DA, Brandt LJ (1997). "Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART I". Am. J. Gastroenterol. 92 (5): 751–62. PMID 9149181.
- ↑ Resnick J, Greenwald DA, Brandt LJ (1997). "Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART II". Am. J. Gastroenterol. 92 (6): 934–40. PMID 9177505.
- ↑ 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.
- ↑ Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC (2017). "Ileus in Adults". Dtsch Arztebl Int. 114 (29–30): 508–518. doi:10.3238/arztebl.2017.0508. PMC 5569564. PMID 28818187.