Reversal of opioid-induced gastric dysfunction in a critically ill burn patient after methylnaltrexone.
Peripheral-acting mu opiate receptor antagonists have been extensively studied for the treatment of opiate-induced constipation in advanced illness for the prophylaxis of postoperative ileus. We document the first intensive care patient to receive methylnaltrexone in an attempt to facilitate enteral nutrition. Gastric residuals markedly decreased and enteral feeding increased after administration of i.v. methylnaltrexone. The patient's ileus resolved coincident with the first injection.
Woo
Michael
M
Department Anesthesia and Critical Care, The University of Chicago, 5841 S. Maryland Ave., MC 4028, Chicago, IL 60637, USA.
O'Connor
Michael
M
Yuan
Chun-Su
CS
Moss
Jonathan
J
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002056:Burns / Q000601:surgery*; D016638:Critical Illness; D004750:Enteral Nutrition; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D009271:Naltrexone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D000644:Quaternary Ammonium Compounds; C032257:methylnaltrexone; D009271:Naltrexone