Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis
Background: Hyperperistalsis 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 paralysi...
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| Veröffentlicht in: | British journal of surgery 2012-11, Vol.99 (11), p.1524-1529 |
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| creator | De Corte, W. Delrue, H. Vanfleteren, L. J. J. Dutré, P. E. M. Pottel, H. Devriendt, D. K. J. C. Van Rooy, F. H. E. C. D'Hondt, M. Carlier, S. Desmet, M. B. |
| description | Background:
Hyperperistalsis 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.
Methods:
Patients 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.
Results:
Twenty‐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).
Conclusion:
Desflurane 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 number: B39620097060 (http://www.clinicaltrials.be). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Anaesthetic agents affect gut motility |
| doi_str_mv | 10.1002/bjs.8883 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1082235214</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1082235214</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3903-d84a6082a51084c7300bbb7d79a320ad29ebf3137a60e47e38c6d4f71c19c4b23</originalsourceid><addsrcrecordid>eNpFkctu1TAQhi0EooeCxBMgb5DYpPiSxM6SVlAuFUhcl9bEccoUxz61E5XDi_C6OO2h3XismW9-6Z-fkKecHXHGxMv-Ih9preU9suGybSrBW32fbBhjquJSyAPyKOcLxrhkjXhIDoQsf9WIDfn7GcIQJ_zjBmo9BrTg6ZywvDHQ-aejGEa_uGAdjSOFAC6Xbkag2xTnaOM1iGEufQxlbYozepx3dFgShnPqYQspZhu3aGle0rlLO5rc5YLX4zyB97SPV86v6nmOU8yYH5MHI_jsnuzrIfn25vXXk7fV2afTdyevziorOyarQdfQMi2g4UzXVhVffd-rQXUgBYNBdK4fJZeqUK5WTmrbDvWouOWdrXshD8mLG93i5nIpHsyE2TrvIbi4ZFNkhZCN4HVBn-3RpZ_cYLYJJ0g78_-YBXi-ByCXM44JgsV8x7W16Gq9ctUNd4Xe7W7nnJk1TFPCNGuY5vj9l7Xe8Zhn9_uWh_TLtEqqxvz4eGqO2w9MfdetqeU_vQ2jLw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1082235214</pqid></control><display><type>article</type><title>Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>De Corte, W. ; Delrue, H. ; Vanfleteren, L. J. J. ; Dutré, P. E. M. ; Pottel, H. ; Devriendt, D. K. J. C. ; Van Rooy, F. H. E. C. ; D'Hondt, M. ; Carlier, S. ; Desmet, M. B.</creator><creatorcontrib>De Corte, W. ; Delrue, H. ; Vanfleteren, L. J. J. ; Dutré, P. E. M. ; Pottel, H. ; Devriendt, D. K. J. C. ; Van Rooy, F. H. E. C. ; D'Hondt, M. ; Carlier, S. ; Desmet, M. B.</creatorcontrib><description>Background:
Hyperperistalsis 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.
Methods:
Patients 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.
Results:
Twenty‐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).
Conclusion:
Desflurane 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 number: B39620097060 (http://www.clinicaltrials.be). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Anaesthetic agents affect gut motility</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.8883</identifier><identifier>PMID: 23001752</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Anesthetics, Inhalation ; Biological and medical sciences ; Body Mass Index ; Double-Blind Method ; Female ; Gastric Bypass - methods ; Gastrointestinal Motility - drug effects ; General aspects ; Humans ; Isoflurane - analogs & derivatives ; Laparoscopy - methods ; Male ; Medical sciences ; Methyl Ethers ; Muscarinic Antagonists - pharmacology ; Prospective Studies ; Scopolamine Hydrobromide - pharmacology</subject><ispartof>British journal of surgery, 2012-11, Vol.99 (11), p.1524-1529</ispartof><rights>Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3903-d84a6082a51084c7300bbb7d79a320ad29ebf3137a60e47e38c6d4f71c19c4b23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.8883$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.8883$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26429482$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23001752$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Corte, W.</creatorcontrib><creatorcontrib>Delrue, H.</creatorcontrib><creatorcontrib>Vanfleteren, L. J. J.</creatorcontrib><creatorcontrib>Dutré, P. E. M.</creatorcontrib><creatorcontrib>Pottel, H.</creatorcontrib><creatorcontrib>Devriendt, D. K. J. C.</creatorcontrib><creatorcontrib>Van Rooy, F. H. E. C.</creatorcontrib><creatorcontrib>D'Hondt, M.</creatorcontrib><creatorcontrib>Carlier, S.</creatorcontrib><creatorcontrib>Desmet, M. B.</creatorcontrib><title>Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Hyperperistalsis 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.
Methods:
Patients 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.
Results:
Twenty‐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).
Conclusion:
Desflurane 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 number: B39620097060 (http://www.clinicaltrials.be). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Anaesthetic agents affect gut motility</description><subject>Adult</subject><subject>Anesthetics, Inhalation</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Gastric Bypass - methods</subject><subject>Gastrointestinal Motility - drug effects</subject><subject>General aspects</subject><subject>Humans</subject><subject>Isoflurane - analogs & derivatives</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methyl Ethers</subject><subject>Muscarinic Antagonists - pharmacology</subject><subject>Prospective Studies</subject><subject>Scopolamine Hydrobromide - pharmacology</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkctu1TAQhi0EooeCxBMgb5DYpPiSxM6SVlAuFUhcl9bEccoUxz61E5XDi_C6OO2h3XismW9-6Z-fkKecHXHGxMv-Ih9preU9suGybSrBW32fbBhjquJSyAPyKOcLxrhkjXhIDoQsf9WIDfn7GcIQJ_zjBmo9BrTg6ZywvDHQ-aejGEa_uGAdjSOFAC6Xbkag2xTnaOM1iGEufQxlbYozepx3dFgShnPqYQspZhu3aGle0rlLO5rc5YLX4zyB97SPV86v6nmOU8yYH5MHI_jsnuzrIfn25vXXk7fV2afTdyevziorOyarQdfQMi2g4UzXVhVffd-rQXUgBYNBdK4fJZeqUK5WTmrbDvWouOWdrXshD8mLG93i5nIpHsyE2TrvIbi4ZFNkhZCN4HVBn-3RpZ_cYLYJJ0g78_-YBXi-ByCXM44JgsV8x7W16Gq9ctUNd4Xe7W7nnJk1TFPCNGuY5vj9l7Xe8Zhn9_uWh_TLtEqqxvz4eGqO2w9MfdetqeU_vQ2jLw</recordid><startdate>201211</startdate><enddate>201211</enddate><creator>De Corte, W.</creator><creator>Delrue, H.</creator><creator>Vanfleteren, L. J. J.</creator><creator>Dutré, P. E. M.</creator><creator>Pottel, H.</creator><creator>Devriendt, D. K. J. C.</creator><creator>Van Rooy, F. H. E. C.</creator><creator>D'Hondt, M.</creator><creator>Carlier, S.</creator><creator>Desmet, M. B.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201211</creationdate><title>Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis</title><author>De Corte, W. ; Delrue, H. ; Vanfleteren, L. J. J. ; Dutré, P. E. M. ; Pottel, H. ; Devriendt, D. K. J. C. ; Van Rooy, F. H. E. C. ; D'Hondt, M. ; Carlier, S. ; Desmet, M. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3903-d84a6082a51084c7300bbb7d79a320ad29ebf3137a60e47e38c6d4f71c19c4b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Anesthetics, Inhalation</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Gastric Bypass - methods</topic><topic>Gastrointestinal Motility - drug effects</topic><topic>General aspects</topic><topic>Humans</topic><topic>Isoflurane - analogs & derivatives</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methyl Ethers</topic><topic>Muscarinic Antagonists - pharmacology</topic><topic>Prospective Studies</topic><topic>Scopolamine Hydrobromide - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Corte, W.</creatorcontrib><creatorcontrib>Delrue, H.</creatorcontrib><creatorcontrib>Vanfleteren, L. J. J.</creatorcontrib><creatorcontrib>Dutré, P. E. M.</creatorcontrib><creatorcontrib>Pottel, H.</creatorcontrib><creatorcontrib>Devriendt, D. K. J. C.</creatorcontrib><creatorcontrib>Van Rooy, F. H. E. C.</creatorcontrib><creatorcontrib>D'Hondt, M.</creatorcontrib><creatorcontrib>Carlier, S.</creatorcontrib><creatorcontrib>Desmet, M. B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Corte, W.</au><au>Delrue, H.</au><au>Vanfleteren, L. J. J.</au><au>Dutré, P. E. M.</au><au>Pottel, H.</au><au>Devriendt, D. K. J. C.</au><au>Van Rooy, F. H. E. C.</au><au>D'Hondt, M.</au><au>Carlier, S.</au><au>Desmet, M. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2012-11</date><risdate>2012</risdate><volume>99</volume><issue>11</issue><spage>1524</spage><epage>1529</epage><pages>1524-1529</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Hyperperistalsis 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.
Methods:
Patients 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.
Results:
Twenty‐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).
Conclusion:
Desflurane 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 number: B39620097060 (http://www.clinicaltrials.be). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Anaesthetic agents affect gut motility</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>23001752</pmid><doi>10.1002/bjs.8883</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 2012-11, Vol.99 (11), p.1524-1529 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Anesthetics, Inhalation Biological and medical sciences Body Mass Index Double-Blind Method Female Gastric Bypass - methods Gastrointestinal Motility - drug effects General aspects Humans Isoflurane - analogs & derivatives Laparoscopy - methods Male Medical sciences Methyl Ethers Muscarinic Antagonists - pharmacology Prospective Studies Scopolamine Hydrobromide - pharmacology |
| title | Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis |
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