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Does Alvimopan Hasten Gastrointestinal Function After Postoperative Ileus?

´╗┐Does Alvimopan Hasten Gastrointestinal Function After Postoperative Ileus?
Delaney CP, Wolff BG, Viscusi ER et al.
Ann Surg. 2007;245:355-363

The aim of this study was to determine if alvimopan, an oral mu-opioid receptor antagonist shortens the time for the return of gastrointestinal function after bowel resection. The authors reviewed the pooled results of three randomized controlled trials where alvimopan was given prior to and after surgery. Patients received either a 6 mg or 12 mg dose. The agent reduced length of stay by 18 hours for patients given a 12 mg dose. It significantly shortened recovery of bowel function and the ability to tolerate food by about 18 hours. There was no change in opioid requirements, and postoperative morbidity was lower in the drug groups than in the controls.

Each year, approximately one-third of a million persons require small or large bowel surgery, so the issue of return of function of the gastrointestinal tract is important. This study pooled the results from 3 independent randomized trials and found that alvimopan speeds the recovery of normal gastrointestinal function. There was no evidence of an increase in complication rate, including disruption of the anastomosis. Cost issues are not considered in the report and patients with laparoscopic therapy were not included.


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