Purpose. The efficacy, safety, pharmacology, pharmacokinetics, drug–drug interactions, and administration of alvimopan for postoperative ileus are reviewed. Summary. Alvimopan is a selective mopioid receptor antagonist with no central nervous system activity. When orally administered after partial smallor largebowel resection in patients with primary anastomosis, alvimopan shortened the return ...

BACKGROUND Chronic pain affects a large number of patients throughout the world and impacts greatly on their quality of life, including the ability of a patient to sleep, go to work, and socialize. Guidance on the use of opioids in chronic pain patients is available from the British Pain Society; however, patients receiving opioid treatment for their pain often suffer from symptoms associated w...

INTRODUCTION Constipation is a distressing side effect of opioid treatment, being so irksome in some cases that patients would rather suffer the pain than the side effect of opioid analgesics. Stool softeners or stimulating laxatives are often ineffective or even aggravate the situation. A new efficacious and safe drug is needed to limit the frequently observed side effects induced by effective...

Pacjenci z przewlekłą chorobą nerek (PChN) stanowią szczególną grupę pacjentów, szczególnie zaawansowaną niewydolnością tego narządu - w okresie predializacyjnym oraz terapii nerkozastępczej. Na farmakokinetykę stosowanych leków, tym analgetyków opioidowych (AO), będzie miał wpływ stopień uszkodzenia nerek, a ostatecznie leczenie nerkozastępcze. Wybór AO kluczowe znaczenie zapewnieniu optymalne...

Postoperative ileus (POI) is a transient loss of coordinated peristalsis precipitated by surgery and exacerbated by opioid pain medication. Ileus causes a variety of symptoms including bloating, pain, nausea, and vomiting, but particularly delays tolerance of oral diet and liquids. Thus POI is a primary determinant of hospital stay after surgery. 'Fast-track' recovery protocols, opioid sparing ...

CONTEXT Opioid-induced bowel dysfunction (OBD) is characterized by constipation, incomplete evacuation, bloating, and increased gastric reflux. OBD occurs both acutely and chronically, in multiple disease states, resulting in increased morbidity and reduced quality of life. OBJECTIVE To compare the efficacy and safety of traditional and peripherally active opioid antagonists vs conventional i...

Major spinal surgery is associated with severe postoperative pain and stress response, bowel dysfunction, and a potential for chronic pain development. Epidural analgesia has been shown to be advantageous compared to intravenous analgesia alone. The aim of the study was to investigate whether postoperative addition of epidural levobupivacaine to intravenous opioid analgesia offers advantage ove...

In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowe...

OBJECTIVES To describe the prevalence of hysterectomy for women aged 18-45 seeking treatment at a chronic pain clinic, to describe patient characteristics (pain intensity, age, smoking status, hormone replacement status, and psychosocial factors) based on opioid and hysterectomy status, and to determine whether hysterectomy status predicted receipt of opioid prescription. DESIGN Retrospective...

Introduction Laxatives are commonly used to treat opioid-induced constipation, the commonest and most bothersome complication of opioids. However, laxatives have a nonspecific action and do not target underlying mechanisms of opioid-induced constipation; their use is associated with abdominal symptoms that negatively impact quality of life. Objective To assess the effects of laxatives in pati...