Postoperative ileus: A pharmacological perspective

Postoperative ileus (POI) is a frequent complication after abdominal surgery. The consequences of postoperative ileus can be potentially serious such as bronchial inhalation or acute functional renal failure. Numerous advances in peri-operative management, particularly early rehabilitation, have made it possible to decrease postoperative ileus. Despite this, the rate of prolonged postoperative ileus remains high and can be as high as 25% of patients in colorectal surgery. From a pathophysiological point of view, postoperative ileus has two phases, an early neurological phase and a later inflammatory phase, to which we could add a 'pharmacological' phase during which analgesic drugs, particularly opiates, play a central role. The aim of this review article is to describe the phases of the pathophysiology of postoperative ileus, to analyse the pharmacological treatments currently available through published clinical trials and finally to discuss the different research areas for potential pharmacological targets.

Automated summary

Postoperative ileus is a common complication after abdominal surgery, which can have serious consequences. Advances in peri-operative management have been made, but the rate of prolonged postoperative ileus remains high. The pathophysiology of postoperative ileus involves an early neurological phase, a later inflammatory phase, and a pharmacological phase. This review article describes these phases and discusses current pharmacological treatments and potential research areas for targeting.