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Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication after Spinal Operation.

Abstract

PURPOSE

To investigate the prevalence of paralytic ileus after spinal operation in the supine or prone operative position and to determine the efficacy of prophylactic gastrointestinal motility medications in preventing symptomatic paralytic ileus after a spinal operation.

MATERIALS AND METHODS

All patients received spinal surgery in the supine or prone operative position. The study period was divided into two phases: first, to analyze the prevalence of radiographic and symptomatic paralytic ileus after a spinal operation, and second, to determine the therapeutic effects of prophylactic gastrointestinal motility medications (postoperative intravenous injection of scopolamine butylbromide and metoclopramide hydrochloride) on symptomatic paralytic ileus after a spinal operation.

RESULTS

Basic demographic data were not different. In the first phase of this study, 27 patients (32.9%) with radiographic paralytic ileus and 11 patients (13.4%) with symptomatic paralytic ileus were observed. Radiographic paralytic ileus was more often noted in patients who underwent an operation in the prone position (p=0.044); whereas the occurrence of symptomatic paralytic ileus was not different between the supine and prone positioned patients (p=0.385). In the second phase, prophylactic medications were shown to be ineffective in preventing symptomatic paralytic ileus after spinal surgery [symptomatic paralytic ileus was observed in 11.1% (4/36) with prophylactic medication and 16.7% (5/30) with a placebo, p=0.513].

CONCLUSION

Spinal surgery in the prone position was shown to increase the likelihood of radiographic paralytic ileus occurrence, but not symptomatic paralytic ileus. Unfortunately, the prophylactic medications to prevent symptomatic paralytic ileus after spine surgery were shown to be ineffective.

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  • Authors+Show Affiliations

    ,

    Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.

    ,

    Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.

    ,

    Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea. nsyoon@gmail.com.

    ,

    Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea.

    ,

    Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea.

    Department of Radiology, Inha University College of Medicine, Incheon, Korea.

    Source

    Yonsei medical journal 56:6 2015 Nov pg 1627-31

    MeSH

    Adjuvants, Anesthesia
    Adult
    Aged
    Antiemetics
    Female
    Gastrointestinal Motility
    Humans
    Injections, Intravenous
    Intestinal Pseudo-Obstruction
    Lumbar Vertebrae
    Male
    Metoclopramide
    Middle Aged
    Postoperative Complications
    Prevalence
    Prone Position
    Prospective Studies
    Radiography
    Republic of Korea
    Scopolamine
    Spinal Fusion
    Supine Position
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    26446646

    Citation

    Oh, Chang Hyun, et al. "Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication After Spinal Operation." Yonsei Medical Journal, vol. 56, no. 6, 2015, pp. 1627-31.
    Oh CH, Ji GY, Yoon SH, et al. Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication after Spinal Operation. Yonsei Med J. 2015;56(6):1627-31.
    Oh, C. H., Ji, G. Y., Yoon, S. H., Hyun, D., Park, H. C., & Kim, Y. J. (2015). Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication after Spinal Operation. Yonsei Medical Journal, 56(6), pp. 1627-31. doi:10.3349/ymj.2015.56.6.1627.
    Oh CH, et al. Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication After Spinal Operation. Yonsei Med J. 2015;56(6):1627-31. PubMed PMID: 26446646.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication after Spinal Operation. AU - Oh,Chang Hyun, AU - Ji,Gyu Yeul, AU - Yoon,Seung Hwan, AU - Hyun,Dongkeun, AU - Park,Hyeong-chun, AU - Kim,Yeo Ju, PY - 2014/03/20/received PY - 2014/12/16/revised PY - 2015/01/03/accepted PY - 2015/10/9/entrez PY - 2015/10/9/pubmed PY - 2016/7/28/medline KW - Spine surgery KW - paralytic ileus KW - position KW - prone KW - supine SP - 1627 EP - 31 JF - Yonsei medical journal JO - Yonsei Med. J. VL - 56 IS - 6 N2 - PURPOSE: To investigate the prevalence of paralytic ileus after spinal operation in the supine or prone operative position and to determine the efficacy of prophylactic gastrointestinal motility medications in preventing symptomatic paralytic ileus after a spinal operation. MATERIALS AND METHODS: All patients received spinal surgery in the supine or prone operative position. The study period was divided into two phases: first, to analyze the prevalence of radiographic and symptomatic paralytic ileus after a spinal operation, and second, to determine the therapeutic effects of prophylactic gastrointestinal motility medications (postoperative intravenous injection of scopolamine butylbromide and metoclopramide hydrochloride) on symptomatic paralytic ileus after a spinal operation. RESULTS: Basic demographic data were not different. In the first phase of this study, 27 patients (32.9%) with radiographic paralytic ileus and 11 patients (13.4%) with symptomatic paralytic ileus were observed. Radiographic paralytic ileus was more often noted in patients who underwent an operation in the prone position (p=0.044); whereas the occurrence of symptomatic paralytic ileus was not different between the supine and prone positioned patients (p=0.385). In the second phase, prophylactic medications were shown to be ineffective in preventing symptomatic paralytic ileus after spinal surgery [symptomatic paralytic ileus was observed in 11.1% (4/36) with prophylactic medication and 16.7% (5/30) with a placebo, p=0.513]. CONCLUSION: Spinal surgery in the prone position was shown to increase the likelihood of radiographic paralytic ileus occurrence, but not symptomatic paralytic ileus. Unfortunately, the prophylactic medications to prevent symptomatic paralytic ileus after spine surgery were shown to be ineffective. SN - 1976-2437 UR - https://www.unboundmedicine.com/medline/citation/26446646/Paralytic_Ileus_and_Prophylactic_Gastrointestinal_Motility_Medication_after_Spinal_Operation_ L2 - https://www.eymj.org/DOIx.php?id=10.3349/ymj.2015.56.6.1627 DB - PRIME DP - Unbound Medicine ER -