Surgery and intestinal motility

Tinckler, L. F.

doi:10.1002/bjs.1800520212

Cited by 60 publications

(28 citation statements)

References 11 publications

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“…Several studies have shown that the inhibition of motility is more persistent in the stomach' 2 and colon3 while activity in the small intestine returns to normal within a few hours after surgery.4 5 Despite extensive studies, the pathophysiology of postoperative ileus remains unclear, although the most widely accepted hypothesis suggests that postoperative ileus is caused by the activation of inhibitory reflexes originating from receptors within the gut wall and from the visceral and parietal peritoneum.6 Two types of reflexes originating within the intestine have been identified; a low threshold spinal reflex and a high threshold peripheral reflex through prevertebral ganglia.6 The efferent pathway is sympathetic7 while the nature of the afferent pathways remains obscure. Diverse treatments aimed at preventing the postoperative inhibition have been described.6 Blockade of the efferent pathway of the inhibitory reflexes by (x-and ,B-adrenergic blocking agents has yielded contradictory results.7-11 Spinal and epidural anaesthesia have been reported to decrease postoperative bowel inhibition.…”

mentioning

confidence: 99%

Effect of intra-abdominal bupivacaine instillation on postoperative colonic motility.

Rimbäck¹,

Cassuto²,

Faxén³

et al. 1986

Gut

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SUMMARY Effect of intra-abdominal instillation of a local anaesthetic, bupivacaine, on postoperative colonic adynamic ileus was studied in a double blind manner in a randomised series of patients undergoing upper laparotomy. Propulsive colonic activity was studied postoperatively with radio-opaque markers and serial abdominal radiographs. Intra-abdominal instillation of bupivacaine 2 mg/kg bw significantly shortened the period of postoperative colonic inhibition (p

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confidence: 99%

Effect of intra-abdominal bupivacaine instillation on postoperative colonic motility.

Rimbäck¹,

Cassuto²,

Faxén³

et al. 1986

Gut

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“…At times this is more prolonged and, if associated with gaseous distension, develops into paralytic ileus. It has been shown in experimental animals that the activity of the small intestine returns to normal within a few hours following surgery (Tinckler, 1965;Baker and Webster, 1968). Early return of activity has also been shown in man using a radiotelemetering capsule (Ross, Watson, and Kay, 1963 (Nachlas, Younis, Roda, and Wityk, 1972;Neely, 1968).…”

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confidence: 99%

“…It has been shown in experimental animals that the activity of the small intestine returns to normal within a few hours following surgery (Tinckler, 1965;Baker and Webster, 1968). Early return of activity has also been shown in man using a radiotelemetering capsule (Ross, Watson, and Kay, 1963).…”

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confidence: 99%

Postoperative motility of the large intestine in man.

Wilson¹

1975

Gut

139

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SUMMARY Motor activity of the colon in the immediate postoperative period has been studied in human subjects using radiotelemetering capsules, radioopaque markers and serial abdominal radiographs.Following operations outside the abdomen there is a delay of about 16 hours before colonic activity returns. After abdominal operations the delay is from 40 to 48 hours.The length of an operation has no significant effect upon the duration of colonic ileus. The amount of postoperative analgesia has no significant effect upon the duration of colonic ileus. Gaseous distension after laparotomy is confined to the colon.It is well recognized that following operation the motility of the gastrointestinal tract is temporarily impaired. At times this is more prolonged and, if associated with gaseous distension, develops into paralytic ileus. It has been shown in experimental animals that the activity of the small intestine returns to normal within a few hours following surgery (Tinckler, 1965;Baker and Webster, 1968). Early return of activity has also been shown in man using a radiotelemetering capsule (Ross, Watson, and Kay, 1963 (Nachlas, Younis, Roda, and Wityk, 1972;Neely, 1968). Most of these studies have been radiological observations of barium in the gastrointestinal tract, and, althoughthestudies have been primarily directed at the stomach, most workers have observed that barium is also held up in the colon. Study of the colon has not been taken further than this one observation.The present study investigates in more detail the motor behaviour of the colon in the postoperative

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“…The traumatization of the visceral and parietal peritoneum is of significant importance in the pathogenesis of postoperative motility disorders. In an animal experiment, Tinckler [19] was able to show an interruption of bowel activity immediately after the peritoneal incision and opening of the abdominal cavity. Manipulations at the greater omentum and at the bowel again stopped the reestablished bowel activity.…”

Section: Discussionmentioning

confidence: 96%