Prophylaxe und Therapie der Magen-Darm-Atonie

摘要

Prolonged postoperative inhibition of coordinated gastrointestinal motility without mechanical obstruction is referred to as postoperative paralytic ileus. Its pathophysiology is multifactorial and has not been completely clarified. Inflammatory response to gastrointestinal surgery contributes to development of postoperative ileus. Furthermore inhibitory neural reflexes, nociceptive stimuli from the central nervous system and neurotransmitters are involved in impaired gastrointestinal motility. Prevention and therapy of postoperative paralytic ileus require multimodal rehabilitation concepts. Reduction of surgical trauma, suitable anesthetic and analgesic techniques (epidural analgesia and non-steroidal anti-inflammatory agents), early postoperative oral feeding and early mobilization may minimize postoperative ileus.