Clinical trial: alvimopan for the management of post‐operative ileus after abdominal surgery: results of an international randomized, double‐blind, multicentre, placebo‐controlled clinical study

Büchler, Markus W.; Seiler, Carola; Monson, J. R. T.; Flamant, Y; Thompson‐Fawcett, Mark; Byrne, Margaret M; Mortensen, Eric; Altman, J. F. B.; Williamson, Russell

doi:10.1111/j.1365-2036.2008.03696.x

Cited by 124 publications

(130 citation statements)

References 39 publications

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“…Although GI recovery and patient outcomes after open bowel resection have been extensively evaluated in large multicenter, randomized, controlled trials, postoperative care pathways and dietary instructions after surgery have not always been well controlled in many LC trials [4,17,[19][20][21][22][23][24][25]. An increasing body of evidence suggests that peri-and postoperative care regimens including optimized pain management, early oral feeding, perioperative fluid management, and early ambulation significantly enhance postoperative recovery and outcomes [26][27][28][29].…”

mentioning

confidence: 99%

Gastrointestinal recovery after laparoscopic colectomy: results of a prospective, observational, multicenter study

et al. 2009

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Mean GI recovery and LOS after LC were accelerated compared with those for patients in open laparotomy bowel resection clinical trials or those reported in large hospital databases (0.7 and 1.7-2.2 days, respectively). Overall POI-related morbidity was similar between the open bowel resection and LC populations, demonstrating that POI continues to present with important morbidity regardless of the surgical approach.

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confidence: 99%

Gastrointestinal recovery after laparoscopic colectomy: results of a prospective, observational, multicenter study

et al. 2009

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“…In fact, a transient inhibition of motility (paralytic or adynamic ileus) occurs in 10%-15% of patients after abdominal surgery [29,30]. One of the potential benefits of using transvisceral incisions is to accelerate patient recovery and return to normal function but there is no data regarding the impact of NOTES on gastrointestinal motility.…”

Section: Discussionmentioning

confidence: 98%

Gastric Emptying is Delayed in Transgastric Notes: A Randomized Study in Swine

Córdova

Guarner-Argente

Martínez-Pallí

et al. 2012

Journal of Surgical Research

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“…Almivopan was tested in 7 prospective randomized placebo controlled, double blind trials involving a total of 3739 patients (Taguchi et al 2001;Wolff et al 2004;Delaney et al 2005;Herzog et al 2006;Viscusi et al 2006;Buchler et al 2008;Ludwig et al 2008). As summarized in Table 2, no significant decreases in infectious complications were observed in the groups receiving the opioid antagonists.…”

Section: Acute Postoperative Pain Therapymentioning

confidence: 99%

Immunosuppressive Effects of Opioids—Clinical Relevance

Brack

Rittner

Stein

2011

J Neuroimmune Pharmacol

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Opioid-induced immunosuppression has been demonstrated in cell culture experiments and in animal models. This is in striking contrast to the paucity of confirmatory studies in humans. This review describes the basic pharmacokinetics and -dynamics of opioid use in patients. It summarizes the major findings on opioid use and infectious complications in intensive care unit (ICU) patients, in patients with acute or chronic non-malignant pain, and in intravenous drug users (IDU). The limitations of studies in each area are discussed. For example, ethical concerns may complicate randomized placebo-controlled trials (RCT) in acute postoperative pain and for a large part of ICU patients. Importantly, most studies in patients with chronic (non-malignant) pain only inadequately report infectious complications in relation to opioid use since their incidence is usually not considered to be drug related. Infectious complications in IDUs are very frequent but cannot easily be distinguished from risk behavior or risk environment. In summary, convincing clinical evidence is lacking that opioids per se increase the rate of infectious complications in most patient categories. From a clinical standpoint, important unresolved issues are i) selection of relevant animal models, ii) opioid selection and discontinuation, and iii) the role of coexisting diseases and concomitant other medications.

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Clinical trial: alvimopan for the management of post‐operative ileus after abdominal surgery: results of an international randomized, double‐blind, multicentre, placebo‐controlled clinical study

Abstract: SUMMARY BackgroundPost-operative ileus (POI) affects most patients undergoing abdominal surgery.

Cited by 124 publications

References 39 publications

Gastrointestinal recovery after laparoscopic colectomy: results of a prospective, observational, multicenter study

Gastrointestinal recovery after laparoscopic colectomy: results of a prospective, observational, multicenter study

Gastric Emptying is Delayed in Transgastric Notes: A Randomized Study in Swine

Immunosuppressive Effects of Opioids—Clinical Relevance

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