• Br J Surg · Nov 2012

    Randomized Controlled Trial

    Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis.

    • W De Corte, H Delrue, L J J Vanfleteren, P E M Dutré, H Pottel, D K J C Devriendt, F H E C Van Rooy, M D'Hondt, S Carlier, and M B Desmet.
    • Department of Anaesthesia, Groeninge Hospital, Kortrijk, Belgium. wouter.decorte@azgroeninge.be
    • Br J Surg. 2012 Nov 1;99(11):1524-9.

    BackgroundHyperperistalsis of the small bowel during laparoscopic surgery may cause mucosal prolapse and reduce exposure, making laparoscopic suturing or stapling more demanding for the surgeon. Although it is commonly accepted that both opioids and volatile anaesthetics induce intestinal paralysis, intestinal hyperactivity during anaesthesia is not uncommon. This randomized trial investigated the effect of different volatile anaesthetics on intestinal motility and the impact on surgeon satisfaction.MethodsPatients scheduled for laparoscopic gastric bypass surgery were randomized to receive sevoflurane or desflurane in a balanced anaesthetic regimen. After surgical exposure peristaltic waves were counted over 1 min in a segment of the jejunum. Following evaluation of intestinal motility, N-butylhyoscine, an antimuscarinic anticholinergic agent that relaxes bowel smooth muscle cells, could be administered if the surgeon judged the intestinal motility as disturbing. The endpoints were number of peristaltic waves and incidence of N-butylhyoscine administration, a surrogate for surgeon satisfaction.ResultsTwenty-two patients were randomized to each group. The groups were similar in age, sex and body mass index. There was a statistically significant difference in intestinal motility between the desflurane and sevoflurane groups: median (range) 7 (0-12) versus 1 (0-10) waves counted over 1 min respectively (P < 0·001). A higher proportion of patients in the desflurane group received N-butylhyoscine (10 of 22 versus 1 of 22 in the sevoflurane group; P = 0·004).ConclusionDesflurane increased intestinal motility and decreased surgeon satisfaction compared with sevoflurane during laparoscopic gastric bypass surgery. A sevoflurane-based anaesthetic protocol can help to avoid disturbing hyperperistalsis.Registration NumberB39620097060 (http://www.clinicaltrials.be).Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…