Neostigmine In Unavoidable Post Operative Ileus: A Randomized Clinical Trial 1163-1168
Dr Ziaee,Endo.Surgical Office,3rd Floor,Erfan Hospial,Bakshayesh Str., West Sarv Sq., Sadat Abad 1998884349 Tel&Fax:098 21 22357142 Email :Sali_ziaee@yahoo.com
Background: This study was aimed to show the effective way to decrease the rate of postoperative ileus.
Design: Prospective clinical randomized trial of neostigmine in 42 patients with ileus after abdominal surgery.
Intervention: Intravenous administration of 2.5 mg of neostigmine in 500 N/S over 30 min, or placebo. Patients who had no response to the initial injection were eligible to receive open-label neostigmine three hours later.
Settings: Abdominal circumference, time to first flatus and defecation, HR and BP after 3 hours of administration, and radiographic colonic measurements were recorded. Patients were followed for recurrence of ileus. All organic causes of ileus excluded from the study.
Results: 20 out of 21 neostigmine patients (95.23%) passed flatus and stools with first administration of Neostigmine administration, whereas none of the placebo-treated patients passed stools (P < 0.001). In pre study abdominal circumference, there was no significant difference, whereas after 3 hours of intervention, it was decreased significantly (100.85 Â±14.61 case group, 124.71 Â± 16.15, P<0.0001). No acute serious adverse effects occurred in both groups.
Conclusion: In patients with acute colonic pseudo-obstruction who have not had a response to conservative therapy, treatment with neostigmine rapidly decompresses the colon.