Intra-Abdominal Activation of a Local Inflammatory Response Within the Human Muscularis Externa During Laparotomy

Kalff, Jörg C.; Türler, Andreas; Schwarz, Nicolas T.; Schraut, Wolfgang H.; Lee, Kenneth K.W.; Tweardy, David J.; Billiar, Timothy R.; Simmons, Richard L.; Bauer, Anthony J.

doi:10.1097/01.sla.0000055742.79045.7e

Cited by 200 publications

(188 citation statements)

References 48 publications

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“…IL-6 cytokines are well known for their role in maintaining postoperative ileus and intestinal permeability disorders. [5][6][7] The diminished cytokine response was associated with more rapid recovery of bowel function, as shown in the present study. The results are consistent with an after surgery, up-regulation and release of the pro-inflammatory cytokines that contribute to postoperative ileus.…”

Section: Discussionsupporting

confidence: 58%

“…The results are consistent with an after surgery, up-regulation and release of the pro-inflammatory cytokines that contribute to postoperative ileus. 7 The attenuated rise in body temperature (0.3°C) observed in the FA group can be attributed to the antipyretic effect of NSAIDs. This effect on fever shows that perioperative, intravenous FA may reduce nitrogen losses after colorectal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Up-regulation of pro-inflammatory cytokines has been shown to contribute to postoperative ileus. 6,7 Accordingly, anesthetic interventions that modulate inflammatory responses might decrease the incidence and the severity of such complications, thereby minimizing morbidity and mortality.…”

mentioning

confidence: 99%

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Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

Tan

Chen

et al. 2008

Can J Anesth/J Can Anesth

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Purpose: Flurbiprofen axetil (FA) is a potent non-steroidal antiinflammatory drug (NSAID). We examined the effects that perioperative intravenous administration of FA, combined with thoracic epidural anesthesia and postoperative patient-controlled epidural analgesia (PCEA), have on bowel function, postoperative pain, and cytokine release, after open colorectal surgery. Methods:This was a prospective, randomized, double-blind, placebo-controlled study. Forty patients were randomly assigned to one of two groups (n = 20 in each group). The FA group patients received FA 1 mg·kg -1 iv, 30 min before and six hours after skin incision; whereas the control group patients received an equal volume of intralipid. Blood cytokine levels were measured before FA administration, at the end of surgery, and six hours and 24 hr postoperatively. All patients received postoperative PCEA for pain control. Analgesic efficacy was evaluated for 72 hr postoperatively using visual analogue scale (VAS) pain scores both at rest and during coughing. Gastrointestinal motility was recorded. Temperature and leukocyte count were measured preoperatively, and 24 hr postoperatively. Results:The times to first bowel movement (87 ± 23 vs 105 ± 19 hr, P = 0.008) and first flatus (63 ± 16 vs 75 ± 11 hr, P = 0.01) were earlier in the FA group compared to the control group. For the first 24 hr, the pain scores in the FA group were also lower during coughing (P < 0.001 compared to control). The plasma concentrations of interleukin (IL)-6 and IL-8 in the FA group were lower, postoperatively (P < 0.01 and P < 0.05, respectively, compared to control). In contrast, the IL-10 levels were significantly increased at six hours, postoperatively, in the FA group (P = 0.009). The total leukocyte count and the incidence of pyrexia were also lower in patients of the FA group (P = 0.001 and P = 0.006, respectively, compared to control). Conclusion:Flurbiprofen axetil may have an anti-inflammatory effect in major abdominal surgery. The combination of perioperative intravenous FA, intraoperative thoracic epidural anesthesia, and postoperative PCEA facilitated recovery of bowel function, enhanced analgesia, and attenuated the cytokine response.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

Tan

Chen

et al. 2008

Can J Anesth/J Can Anesth

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“…Although the exact causes of postoperative ileus are not fully understood, it has been postulated that an imbalance of sympathetic and parasympathetic inputs to the GI tract results in a reduction in propulsive motility, contributing to or causing signs of ileus [6][7][8]20].…”

Section: Discussionmentioning

confidence: 99%

“…Although other causes have been proposed [1], POI is supposedly caused by surgical manipulation and inflammation [6][7][8]. Many therapies have been proposed to prevent and treat POI in horses [9] but to date none is considered fully effective.…”

Section: Introductionmentioning

confidence: 99%

Effects of Bit Chewing on Right Upper Quadrant Intestinal Sound Frequency in Adult Horses

Giusto

Pagliara

Gandini

2014

Journal of Equine Veterinary Science

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Motility of the Small Intestine and Colon

Bharucha¹,

Hasler²

2015

Yamada' S Textbook of Gastroenterology

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Intra-Abdominal Activation of a Local Inflammatory Response Within the Human Muscularis Externa During Laparotomy

Abstract: These human data demonstrate that surgical trauma is followed by resident muscularis macrophage activation and the upregulation, release, and functional activity of proinflammatory cytokines and kinetically active mediators.

Cited by 200 publications

References 48 publications

Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

Effects of Bit Chewing on Right Upper Quadrant Intestinal Sound Frequency in Adult Horses

Motility of the Small Intestine and Colon

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