The Role of Anesthetic Techniques and Drugs in Laparotomy Cases of Postoperative Ileus

Eka Ari Puspita(1), Yudhistiro Andri Nugroho(2), Naomi Rahmasena(3), Ahmad Mochtar Jamil(4), Ulaa Haniifah(5), Muhammad Anas(6*), Laila Rahmah(7)


(1) Departement of Anaestesi of RSUD Soegiri Lamongan, Lamongan, East Java, Indonesia
(2) Departement of Anaestesi of RSUD Soegiri Lamongan, Lamongan, East Java, Indonesia
(3) Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(4) Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(5) Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(6) [Scopus ID: 57192299850] Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(7) School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
(*) Corresponding Author

Abstract


Background: Ileus occurs when there is a non-mechanical decrease or stoppage of the flow of intestinal contents. The cause of ileus has yet to be clearly defined. Various factors influence the risk for an ileus, each affecting a small part of the complex neuroimmune system. The patient will present with bloating and abdominal distension. Plain abdominal films and computed tomography (CT) scans of the abdomen are usually the first diagnostic imaging obtained. The most important principle for treating ileus is treating the underlying cause. Treating the infection, electrolyte abnormalities, and decreasing opiate use can all potentially decrease the durability of an ileus. Anesthesia procedures must be performed to treat patients preoperatively, during surgery, and postoperatively. Enhanced recovery protocols, regional anesthesia, opioid-sparing analgesics, and laparoscopy have all improved the number of postoperative ileus cases.

Case Presentation: The following is a 67-year-old male patient who presents with abdominal pain with a scale of 4 out of 10, diagnosed with ileus, which was planned for laparotomy surgery by general anesthesia with supine position.

Conclusion:We conclude that anesthetic procedures are critical in ileus patients in performing laparotomy operations, both in selecting anesthetic techniques, anesthetic drugs, and supporting scores (Aldrete score). Before induction, anesthesiologists must carefully assess preoperative and monitor postoperative

 


Keywords


Ileus; paralitic; laparoscopy; postoperative; lawn

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References


Venara A, Neunlist M, Slim K, Barbieux J, Colas PA, Hamy A, et al. Postoperative ileus: pathophysiology, incidence, and prevention. J Visc Surg. 2016;153(6):439–46.

Nazzani S, Bandini M, Preisser F, Mazzone E, Marchioni M, Tian Z, et al. Postoperative paralytic ileus after major oncological procedures in the enhanced recovery after surgery era: A population based analysis. Surg Oncol. 2019;28:201–7.

Beach EC, Jesus O De. Ileus. Encycl Gastroenterol Second Ed [Internet]. 2023 20 June [cited 2023 24 October];241–3. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558937/

Sinicrope FA. Ileus and Bowel Obstruction. In: Kufe DW, Pollock RE, Weichselbaum RR et al., editor. Holland-Frei Cancer Medicine [Internet]. 6th editio. Hamilton: BC Decker; 2003 [cited 2023 24 October]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK13786/

Gero D, Gié O, Hübner M, Demartines N, Hahnloser D. Postoperative ileus: in search of an international consensus on definition, diagnosis, and treatment. Langenbeck’s Arch Surg. 2017;402(1):149–58.

Buchanan L, Tuma F. Postoperative Ileus. Perioper Med Consult Handb Third Ed [Internet]. 2023 31 July [cited 2023 24 October];423–32. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560780/

Butterworth IV JF, Mackey DC, Wasnick JD. Morgan & Mikhail's clinical anesthesiology. Clinical Anesthesiology. McGrawHill Education; 2013.

Vilz TO, Stoffels B, Straßburg C, Schild HH, Kalff JC. Ileus in adults - Pathogenesis, investigation and treatment. Dtsch Arztebl Int. 2017;114(29–30):508–17.

Ballantyne JC, Longnecker DE, Brown DL, Newman MF, Zapol WM. Management of Acute Postoperative Pain: Current Recommendations. J Med Sci. 2017;3(1):0–0.

Froese AB, Bryan AC. Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology. 1974;41(3):242–55.

Balasa A, Hurghis CI, Tamas F, Chinezu R. Patient Positioning in Neurosurgery, Principles and Complications. Acta Marisiensis - Ser Medica. 2020;66(1):9–14.

Hopkins TJ, Raghunathan K, Barbeito A, Cooter M, Stafford-Smith M, Schroeder R, et al. Associations between ASA Physical Status and postoperative mortality at 48 h: a contemporary dataset analysis compared to a historical cohort. Perioper Med. 2016;5(1):1–6.

Hemanth Kumar VR, Saraogi A, Parthasarathy S, Ravishankar M. A useful mnemonic for pre-anesthetic assessment. J Anaesthesiol Clin Pharmacol. 2013;29(4):560–1.

ATLS subcommittee. American College of Surgeons' Committee on Trauma; International ATLS working group. Adv trauma life Support ninth Ed J Trauma Acute Care Surg. 2013;74(5):1363–6.

American Society of Anesthesiologists Committee. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures. Anesthesiology. 2017 Mar 1;126(3):376–93.

Capey S. Isoflurane. xPharm Compr Pharmacol Ref [Internet]. 2007 8 August [cited 2023 24 October];1–4. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532957/

Ong Sio LC, Dela Cruz RG, Bautista A. A comparison of renal responses to sevoflurane and isoflurane in patients undergoing donor nephrectomy: A randomized controlled trial. Med Gas Res. 2017;7(1):19–27.


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DOI: https://doi.org/10.26714/magnamed.11.1.2024.97-107

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