| Objective: Colonic carcinoma is one of the common malignant tumor ofgastrointestinal tract. in recent years,morbidity of colonic carcinomaIncreases significantly. Surgical operation is still main and effectivetreatment of colonic carcinoma.But no matter celiotomy or laparoscope tooperate radical coloectomy, postoperative ileus is still a common andinevitable complication after abdominal operation. It can increasepostoperative complications, hospital length of stay (LOS) and medicalexpense. Alvimopan is a mu opioid receptor antagonist that blocks theeffects ofopioids on the intestine, while not interfering with their centrallymediated analgesic effect. Purpose of this article is to evaluate the safetyand effect of orally Alvimopan on the recovery of gastrointestinalmotility after radical coloectomy. Methods: sixty-six colon cancer patients who had radical coloectomywere enrolled and grouped into treatment group（32cases）versus controlgroup (34cases) in this prospective study. All patients were givenAlvimopan or placebo12mg dose preoperative one time andpostoperateive twice per day,until tolerate solid food or bowelmovement,or at most intake the medicine totle7days. All patientsreceived general anesthesia tracheal intubation. Postoperative analgesicmethod: patient-controlled intravenous analgesia (PCIA)which sulfentanyl concentration is1.5ug/ml, total96ml,2ml/h asconstant speed for48hours. To listen and record bowel sound withstethoscope the day before operation(9、15h)and seven days postoperativeor hospital discharge. Record the first time to pass gas, bowel movement,tolerate solid diet(nausea,womit, abdominal distension or not in4hoursaftet diet) and hospital length of stay (LOS). To assess Visual AnalogueScale (VAS) scores of postoperative24、48h. then reexamining relevantresults after drug withdrawal to evaluate the safety of alimopan. allmeasurement dates were presented as mean±standarddeviation．Categorical datas were presented as absolute number or relativenumber. T-test or chi-sguare(2) test was used to compare all demographicdatas between groups,.All datas were analyzed with SPSS11.0forwindows,p value <0.05was considered to be significant． Results: GI2(first bowel movement, time to first flatus and time totoleration of solid diet)of treat group were51.9310.08h,73.2117.23h,90.2127.02h;GI2of control group were69.2415.85h,98.6528.81h,118.3430.11h,P<0.05, there had statistically significantdifference between two groups. All patients use sulfentanyl（opioid-based analgesia） to PCIA after operation for48hours. Allpatients did not need to add any other analgesic After Surgery. Treatgroup’s VAS scores of postoperative24、48h were3.231.02，2.311.41;control group’s VAS scores of postoperative24、48h were3.441.35，2.280.97, P>0.05, there had no statistically significant differencebetween two groups. Time to first defecation and LOS of treat groupwere89.6629.3h,8.441.37d; Time to first defecation and LOS ofcontrol group were117.427.54h,13.64.22d， P<0.05, there hadstatistically significant difference between two groups.All patientsreexamining relevant results(include routine blood test, liverfunction,renal function,ECG, routine urine test, Myocardial enzymes et al.)after drug withdrawal had no statistically significant difference betweentwo groups.（P>0.05）. none of patients died or had Seriouscomplications between hospitalization.Conclusion: Alvimopan could significantly improve the recovery ofgastrointestinal mobility after radical coloectomy, reduce LOS, not interferanalgesic effect safe and effect,no Serious complications,is worthy of promotion and application... |
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