In-hospital use of opioids increases rate of coded postoperative paralytic ileus.
OBJECTIVE
To determine the association between opioid use and the occurrence of postoperative paralytic ileus (POI) after different types of surgery.


METHODS
The PHARMO database was used to perform a case control study in which intramural drug utilisation data were linked to hospital discharge diagnoses. All patients admitted for digestive, abdominal or genito-urinary surgeries were selected in 1998-2003. Cases with coded POI (ICD-9-CM 560.1 and 564.4) and controls with no POI were matched 1:10. The association between coded POI and opioid use was assessed using conditional logistic regression.


RESULTS
In 0.2% of all admissions (total of 180,279), patients developed POI and in 18% of all admissions, patients received opioids. Three hundred and sixty-six cases with POI were selected with their matching controls. The use of (nico)morphine was associated with the risk for developing POI (odds ratio (OR) 12.1, 95% confidence interval (CI) 5.4-27.1). The association between opioids and POI was most obvious in patients with abdominal surgery (OR 33.8, 95% CI 6.2-184.6) and patients without colon/colorectal/rectal tumours (OR 13.2, 95%CI 5.7-30.3).


CONCLUSIONS
This study demonstrated a distinct association between the use of opioids, in particular natural opium alkaloids, and the risk for coded POI.
Goettsch
Wim G
WG
PHARMO Institute, Utrecht, The Netherlands.
Sukel
Myrthe P P
MP
van der Peet
Donald L
DL
van Riemsdijk
Melanie M
MM
Herings
Ron M C
RM
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D045823:Ileus / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology
D000701:Analgesics, Opioid