Authors: P. Maruna 1,2; R. Gürlich 3,4; R. Fraško 4 Authors‘ workplace: Ústav patologické fyziologie, 1. lékařská fakulta UK Praha přednosta prof. MUDr. E. Nečas, DrSc. 1; III. interní klinika Všeobecná fakultní nemocnice a 1. lékařská fakulta UK Praha přednosta prof. MUDr. Š. Svačina, DrSc. 2; Klinika transplantační chirurgie IKEM, přednosta doc. MUDr. M. Adamec, CSc. 3; I. chirurgická klinika Všeobecná fakultní nemocnice a 1. lékařská fakulta UK Praha přednosta doc. MUDr. J. Šváb, CSc. 4 Published in: Rozhl. Chir., 2005, roč. 84, č. 7, s. 356-362. Category: Monothematic special - Original
The postoperative motility dysfunction (POI) is a frequent secondary complication of surgical procedures. The POI results from a number of simultaneous factors of both local and systemic nature. Activation of inhibitory neural reflexes and a mediator response to the surgical procedure are among the main ones. Neurohumoral response of the organism to painful stimuli and the effect of the opioid medication used during the perioperative period, are the modulating factors. The intraabdominal procedure with manipulation with the intestine results in activation of the mediator response, followed by increased levels of cytokines and other mediators, inhibiting the smooth intestinal musculature contractility. The extent of the traumatization of the tissue is a principal factor affecting the extent and duration of the POI.
Key words: laparotomy – opioids – postoperative ileus – inflammation
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