Efficacy of metoclopramide for treatment of ileus in horses following small intestinal surgery: 70 cases (1989-1992).
In this retrospective study, postoperative ileus was studied in horses having resection of the small intestine followed by a jejunojejunal (n = 35) or a jejunocaecal (n = 35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intravenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour). Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P < 0.001), shorter duration (P < 0.001), and a slower rate (P < 0.001) of postoperative gastric reflux, and a shorter postoperative hospital stay (P < 0.01) when compared to horses receiving no metoclopramide and horses receiving metoclopramide as an intermittent infusion. Horses having jejunocaecostomy performed had a larger volume (P < 0.05), longer duration (P < 0.05), and a greater rate (P < 0.05) of postoperative gastric reflux, and a longer postoperative hospital stay (P < 0.001) than horses undergoing jejunojejunostomy. Horses that had an abdominal drain placed during surgery had a longer length of intestine resected (P < 0.05) and a longer postoperative hospital stay (P < 0.05) than horses without an abdominal drain. Horses that died or were euthanased during the postoperative period had a greater total volume (P < 0.05), longer duration (P < 0.05), and greater rate of postoperative gastric reflux (P < 0.01), a longer length of small intestine resected (P < 0.01), and a shorter postoperative hospital stay (P < 0.05) than horses that survived until discharge from the hospital. In a multivariate regression analysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P < 0.001; r2 = 0.24), duration (P < 0.001; r2 = 0.24) and rate (P < 0.001; r2 = 0.25) of postoperative gastric reflux. We concluded that metoclopramide given as a continuous intravenous infusion decreased the incidence and severity of ileus following small intestinal resection and anastomosis in horses.
Dart
A J
AJ
Veterinary Medical Teaching Hospital, University of California, Davis 95616, USA.
Peauroi
J R
JR
Hodgson
D R
DR
Pascoe
J R
JR
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000662:veterinary; D000818:Animals; D002431:Cecostomy / Q000009:adverse effects / Q000662:veterinary; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D004322:Drainage / Q000009:adverse effects / Q000662:veterinary; D006734:Horse Diseases / Q000188:drug therapy* / Q000401:mortality; D006736:Horses; D007262:Infusions, Intravenous / Q000379:methods / Q000662:veterinary; D007415:Intestinal Obstruction / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000662:veterinary*; D007421:Intestine, Small / Q000601:surgery*; D007582:Jejunostomy / Q000009:adverse effects / Q000662:veterinary; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000662:veterinary*; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate
D018492:Dopamine Antagonists; D008787:Metoclopramide