Surgery>>>>>Patient Safety
Question 7#

Which of the following have been shown to decrease the time of postoperative ileus? 

A. Cyclooxygenase-1 inhibitors
B. Morphine patient -controlled analgesia
C. Nasogastric drainage until full return of bowel function
D. Erythromycin

Correct Answer is D

Comment:

Pharmacologic agents commonly used to stimulate bowel function include metoclopramide and erythromycin. Metoclopramide's action is limited to the stomach and duodenum, and it may help primarily with gastroparesis. Erythromycin is a motilin agonist that works throughout the stomach and bowel. Several studies demonstrate significant benefit from the administration of erythromycin in those suffering from an ileus. Alvimopan, a newer agent and a mu-opioid receptor antagonist, has shown some promise in many studies for earlier return of gut function and subsequent reduction in length of stay. Neostigmine has been used in refractory pan-ileus patients (Ogilvie syndrome) with some degree of success. It is recommended for patients receiving this type of therapy to be in a monitored unit.