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Review
. 2022 Jan;92(1-2):69-76.
doi: 10.1111/ans.17418. Epub 2021 Dec 19.

The impact of acetylcholinesterase inhibitors on ileus and gut motility following abdominal surgery: a clinical review

Luke Traeger  1   2 , Hidde M Kroon  1   2 , Sergei Bedrikovetski  1   2 , James W Moore  1   2 , Tarik Sammour  1   2
Affiliations
Review

The impact of acetylcholinesterase inhibitors on ileus and gut motility following abdominal surgery: a clinical review

Luke Traeger et al. ANZ J Surg. 2022 Jan.

Abstract

Postoperative ileus is a common complication in the days following colorectal surgery occurring in up to 50% of patients. When prolonged, this complication results in significant morbidity and mortality, doubling the total costs of hospital stay. Postoperative ileus (POI) results from the prolonged inflammatory phase that is mediated in part by the cholinergic anti-inflammatory pathway. Acetylcholinesterase inhibitors, such as neostigmine and pyridostigmine, delay the degradation of acetylcholine at the synaptic cleft. This increase in acetylcholine has been shown to increase gut motility. They have been effective in the treatment of acute colonic pseudo-obstruction, but there is limited evidence for the use of these medications for reducing the incidence of POI. This review was conducted to summarise the evidence of acetylcholinesterase inhibitors' effect on gut motility and discuss their potential use as part of an enhanced recovery protocols to prevent or treat POI.

Keywords: colorectal surgery; ileus; neostigmine; pyridostigmine.

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References

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