Giraldi G, De Luca d'Alessandro E, Mannocci A, Vecchione V, Martinoli L
Department of Public Health and Infectious Diseases, Ospedale Sant'Andrea, Rome, Italy.
Clin Ter. 2012;163(3):e121-6.
Post-operative ileus can also occur in other types of surgery not strictly related to abdomen. The objective of this study was to investigate the efficacy of pantothenic acid administration to stimulate intestinal peristalsis in case of post-operative ileus and estimate the most effective dose. This vitamin can be used for the treatment of chronic atonic intestine or for chronic constipation, but therapeutic indications are not precise in these conditions.
This pilot study has used patients divided in groups treated in post-operative period with physiological solution for patients in control group (Placebo) and Dexpantenolo, which is a derivative in alcohol of pantothenic acid, for all the actively treated patients. The treatments were administered intravenously during the second and third post-operative day, according to the treatment schedule.
60 patients were recruited and they were allocated to five treatment groups or one control group. For males, the median time of the first bowel evacuation was 90 hours while for females the median time was 84 hours (p=0.891). For patients who received a spinal anesthetic, the median time was 72 hours, while for those who received a peridural anesthetic the median time was 96 hours (p=0.571). Between six treatment groups, instead, there is a significant difference between the median times from the operation to the first bowel evacuation (p<0.001). Linear regression model obtained using as outcome evacuation hours after surgery show that only variable which significantly affects time between operation and the first bowel evacuation is treatment dose (Beta = -0.868, p<0.001).
This study would seem to indicate that pantothenic acid is effective for treatment of post-operative intestinal ileus; there is a dose response relationship between pantothenic acid and the decreasing time from surgical operation to first bowel evacuation. However, this study is preliminary; further studies are necessary, preferably randomized and with a larger number of patients.
术后肠梗阻也可发生在与腹部无严格关联的其他类型手术中。本研究的目的是探讨给予泛酸以刺激术后肠梗阻患者肠道蠕动的疗效，并估算最有效的剂量。这种维生素可用于治疗慢性无力性肠病或慢性便秘，但在这些情况下治疗指征并不明确。
本前瞻性研究将患者分为几组，对照组（安慰剂组）患者在术后接受生理盐水治疗，所有积极治疗组的患者接受右泛醇治疗，右泛醇是泛酸的醇衍生物。根据治疗方案，在术后第二天和第三天静脉给药。
招募了60名患者，他们被分配到五个治疗组或一个对照组。男性首次排便的中位时间为90小时，而女性为84小时（p = 0.891）。接受脊髓麻醉的患者中位时间为72小时，而接受硬膜外麻醉的患者中位时间为96小时（p = 0.571）。相反，在六个治疗组之间，从手术到首次排便的中位时间存在显著差异（p < 0.001）。以术后排便时间为结果变量建立的线性回归模型显示，唯一显著影响手术与首次排便之间时间的变量是治疗剂量（β = -0.868，p < 0.001）。
本研究似乎表明泛酸对治疗术后肠梗阻有效；泛酸与从手术到首次排便时间的缩短之间存在剂量反应关系。然而，本研究是初步的；需要进一步的研究，最好是随机且纳入更多患者的研究。
