Inhibition of sympathetic pathways restores postoperative ileus in the upper and lower gastrointestinal tract.
OBJECTIVE
Postoperative ileus (POI) is a transient bowel dysmotility following abdominal surgery. The effects of adrenergic blocking agents and celiac ganglionectomy were studied in rats to investigate the possible involvement of the adrenergic pathway in whole gastrointestinal (GI) transit in the early and late phases of POI.


METHODS
After laparotomy, the terminal ileum was manipulated for 10 min. (51)Cr was administered into the stomach or colon immediately after surgery. In another group, (51)Cr was administered 24 h after surgery. Three hours after (51)Cr was administered, the rats were killed, and GI and colonic transit was calculated as a geometric center (GC).


RESULTS
Gastrointestinal transit was significantly delayed 3 h after intestinal manipulation, compared with GI transit in rats that had anesthesia only. Three hours after intestinal manipulation, guanethidine (5 mg/kg) and yohimbine (3 mg/kg) significantly improved delayed GI transit. Celiac ganglionectomy also significantly improved delayed GI transit. Twenty-seven hours after intestinal manipulation, guanethidine, yohimbine and celiac ganglionectomy improved delayed GI transit induced by intestinal manipulation. Colonic transit was delayed 3 h after intestinal manipulation, and delayed colonic transit was partially restored within 27 h of intestinal manipulation. Guanethidine, yohimbine and celiac ganglionectomy improved delayed colonic transit 3 h and 27 h after intestinal manipulation.


CONCLUSIONS
Adrenoceptors activated by intestinal manipulation impair the motility of the entire GI tract in both the early and the late phase of POI.
Fukuda
Hiroyuki
H
Department of Surgery, Duke University Medical Center and VA Medical Center, Durham, North Carolina, USA.
Tsuchida
Daisuke
D
Koda
Keiji
K
Miyazaki
Masaru
M
Pappas
Theodore N
TN
Takahashi
Toku
T
D000005:Abdomen / Q000601:surgery; D018674:Adrenergic Antagonists / Q000494:pharmacology; D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology; D000818:Animals; D005728:Ganglia, Sympathetic; D015171:Ganglionectomy; D005772:Gastrointestinal Transit / Q000187:drug effects / Q000502:physiology*; D006145:Guanethidine / Q000494:pharmacology; D045823:Ileus / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D015016:Yohimbine / Q000494:pharmacology
D018674:Adrenergic Antagonists; D000317:Adrenergic alpha-Antagonists; D015016:Yohimbine; D006145:Guanethidine