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. 1986 Feb;27(2):170–175. doi: 10.1136/gut.27.2.170

Effect of intra-abdominal bupivacaine instillation on postoperative colonic motility.

G Rimbäck, J Cassuto, A Faxén, S Högström, G Wallin, P O Tollesson
PMCID: PMC1433201  PMID: 3949246

Abstract

Effect of intra-abdominal instillation of a local anaesthetic, bupivacaine, on postoperative colonic adynamic ileus was studied in a double blind manner in a randomised series of patients undergoing upper laparotomy. Propulsive colonic activity was studied postoperatively with radio-opaque markers and serial abdominal radiographs. Intra-abdominal instillation of bupivacaine 2 mg/kg bw significantly shortened the period of postoperative colonic inhibition (p less than 0.01), but did not hasten colonic transit. Furthermore, bupivacaine significantly decreased the hyperglycaemic response to surgery. It is suggested that bupivacaine inhibits the inflammatory response within the bowel wall, a response which may maintain the inhibitory spinal reflexes in the postoperative period. Blood concentrations of bupivacaine were shown to be well below toxic levels and no adverse reactions were observed.

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Selected References

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  1. Acalovschi I., Badea G. Eficienţa anesteziei peridurale continue (intermitentă) în prevenirea ileusului postoperator. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1978 Jul-Aug;27(4):315–318. [PubMed] [Google Scholar]
  2. Biber B., Fara J. Intestinal motility increased by tetrodotoxin, lidocaine, and procaine. Experientia. 1973 May 15;29(5):551–552. doi: 10.1007/BF01926658. [DOI] [PubMed] [Google Scholar]
  3. Bortoff A., Muller R. Stimulation of intestinal smooth muscle by atropine, procaine, and tetrodotoxin. Am J Physiol. 1975 Dec;229(6):1609–1613. doi: 10.1152/ajplegacy.1975.229.6.1609. [DOI] [PubMed] [Google Scholar]
  4. Bromage P. R., Shibata H. R., Willoughby H. W. Influence of prolonged epidural blockade on blood sugar and cortisol responses to operations upon the upper part of the abdomen and the thorax. Surg Gynecol Obstet. 1971 Jun;132(6):1051–1056. [PubMed] [Google Scholar]
  5. Brunsson I., Sjöqvist A., Jodal M., Lundgren O. Mechanisms underlying the intestinal fluid secretion evoked by nociceptive serosal stimulation of the rat. Naunyn Schmiedebergs Arch Pharmacol. 1985 Feb;328(4):439–445. doi: 10.1007/BF00692913. [DOI] [PubMed] [Google Scholar]
  6. Di Rosa M., Giroud J. P., Willoughby D. A. Studies on the mediators of the acute inflammatory response induced in rats in different sites by carrageenan and turpentine. J Pathol. 1971 May;104(1):15–29. doi: 10.1002/path.1711040103. [DOI] [PubMed] [Google Scholar]
  7. Fasano M., Waldvogel H. H., Muller C. A. Prophylaxie de l'iléus paralytique après chirurgie du côlon par blocage sympathique péridural continu. Rapport préliminaire. Helv Chir Acta. 1979 May;46(1-2):245–248. [PubMed] [Google Scholar]
  8. Furness J. B., Costa M. Adynamic ileus, its pathogenesis and treatment. Med Biol. 1974 Apr;52(2):82–89. [PubMed] [Google Scholar]
  9. Graber J. N., Schulte W. J., Condon R. E., Cowles V. E. Relationship of duration of postoperative ileus to extent and site of operative dissection. Surgery. 1982 Jul;92(1):87–92. [PubMed] [Google Scholar]
  10. Heimbach D. M., Crout J. R. Treatment of paralytic ileus with adrenergic neuronal blocking drugs. Surgery. 1971 Apr;69(4):582–587. [PubMed] [Google Scholar]
  11. Janik J. S., Apkarian R., Nagaraj H. S., Groff D. B. An ultrastructural study of enteric serosa after surgical management. Surg Gynecol Obstet. 1982 Apr;154(4):491–496. [PubMed] [Google Scholar]
  12. Kinnaert P., Panda M., Deuvaert F. Use of chlorpromazine in the treatment of adynamic ileus. World J Surg. 1977 Sep;1(5):655–660. doi: 10.1007/BF01556202. [DOI] [PubMed] [Google Scholar]
  13. MacGregor R. R., Thorner R. E., Wright D. M. Lidocaine inhibits granulocyte adherence and prevents granulocyte delivery to inflammatory sites. Blood. 1980 Aug;56(2):203–209. [PubMed] [Google Scholar]
  14. Mather L. E., Tucker G. T. Meperidine and other basic drugs: general method for their determination in plasma. J Pharm Sci. 1974 Feb;63(2):306–307. doi: 10.1002/jps.2600630232. [DOI] [PubMed] [Google Scholar]
  15. Moore D. C., Mather L. E., Bridenbaugh L. D., Thompson G. E., Balfour R. I., Lysons D. F., Horton W. G. Bupivacaine (Marcaine): an evaluation of its tissue and systemic toxicity in humans. Acta Anaesthesiol Scand. 1977;21(2):109–121. doi: 10.1111/j.1399-6576.1977.tb01201.x. [DOI] [PubMed] [Google Scholar]
  16. Nachlas M. M., Younis M. T., Roda C. P., Wityk J. J. Gastrointestinal motility studies as a guide to postoperative management. Ann Surg. 1972 Apr;175(4):510–522. doi: 10.1097/00000658-197204000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Neely J., Catchpole B. Ileus: the restoration of alimentary-tract motility by pharmacological means. Br J Surg. 1971 Jan;58(1):21–28. doi: 10.1002/bjs.1800580104. [DOI] [PubMed] [Google Scholar]
  18. Petri G., Szenohradszky J., Porszasz-Gibiszer K. Sympatholytic treatment of "paralytic" ileus. Surgery. 1971 Sep;70(3):359–367. [PubMed] [Google Scholar]
  19. ROTHNIE N. G., HARPER R. A., CATCHPOLE B. N. Early postoperative gastrointestinal activity. Lancet. 1963 Jul 13;2(7298):64–67. doi: 10.1016/s0140-6736(63)90064-3. [DOI] [PubMed] [Google Scholar]
  20. Seeman P. The membrane actions of anesthetics and tranquilizers. Pharmacol Rev. 1972 Dec;24(4):583–655. [PubMed] [Google Scholar]
  21. Smith J., Kelly K. A., Weinshilboum R. M. Pathophysiology of postoperative ileus. Arch Surg. 1977 Feb;112(2):203–209. doi: 10.1001/archsurg.1977.01370020097011. [DOI] [PubMed] [Google Scholar]
  22. TINCKLER L. F. SURGERY AND INTESTINAL MOTILITY. Br J Surg. 1965 Feb;52:140–150. doi: 10.1002/bjs.1800520212. [DOI] [PubMed] [Google Scholar]
  23. Tanaka K., Iizuka Y. Suppression of enzyme release from isolated rat liver lysosomes by non-steroidal anti-inflammatory drugs. Biochem Pharmacol. 1968 Oct;17(10):2023–2032. doi: 10.1016/0006-2952(68)90175-5. [DOI] [PubMed] [Google Scholar]
  24. Wilson J. P. Postoperative motility of the large intestine in man. Gut. 1975 Sep;16(9):689–692. doi: 10.1136/gut.16.9.689. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Wood J. D. Electrical activity from single neurons in Auerbach's plexus. Am J Physiol. 1970 Jul;219(1):159–169. doi: 10.1152/ajplegacy.1970.219.1.159. [DOI] [PubMed] [Google Scholar]
  26. Wood J. D., Marsh D. R. Effects of atropine, tetrodotoxin and lidocaine on rebound excitation of guinea-pig small intestine. J Pharmacol Exp Ther. 1973 Mar;184(3):590–598. [PubMed] [Google Scholar]
  27. Woods J. H., Erickson L. W., Condon R. E., Schulte W. J., Sillin L. F. Postoperative ileus: a colonic problem? Surgery. 1978 Oct;84(4):527–533. [PubMed] [Google Scholar]

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