Kraft Michael, Maclaren Robert, Du Wei, Owens Gay
P T. 2010 Jan;35(1):44-9.
Postoperative ileus (POI) after open abdominal surgery and bowel resection can lead to significant patient discomfort, morbidity, and prolonged length of stay in the hospital. Several factors have been implicated in the pathophysiology of POI, including surgical manipulation of the bowel, inflammation, inhibitory neural reflexes, and endogenous and exogenous opioids. Alvimopan (Entereg), approved by the FDA to accelerate upper and lower gastrointestinal (GI) recovery following partial large-bowel or small- bowel resection with primary anastomosis, represents a potential advance in the care of these patients. In five randomized, double-blind, placebo-controlled, phase 3 clinical trials, alvimopan, compared with placebo, accelerated the time to GI recovery and hospital discharge status after bowel resection. In this article, we review the formulary details of alvimopan for in-hospital management of POI following this procedure.
开腹手术和肠切除术后的术后肠梗阻（POI）可导致患者明显不适、发病，并延长住院时间。POI的病理生理学涉及多个因素，包括肠道手术操作、炎症、抑制性神经反射以及内源性和外源性阿片类药物。阿维莫潘（Entereg）已获美国食品药品监督管理局（FDA）批准，用于在部分大肠或小肠切除并进行一期吻合术后加速上、下胃肠道（GI）恢复，这代表了这些患者护理方面的一项潜在进展。在五项随机、双盲、安慰剂对照的3期临床试验中，与安慰剂相比，阿维莫潘加速了肠切除术后胃肠道恢复时间和出院状态。在本文中，我们回顾了阿维莫潘用于该手术后住院期间POI管理的处方细节。
