Subcutaneous methylnaltrexone to restore postoperative bowel function in a long-term opiate user.
BACKGROUND
One of the most common undesired effects of analgesic opioid use and addiction is constipation. Numerous pharmacologic agents have been used to treat opioid-induced bowel hypomotility with limited success. Methylnaltrexone bromide (MNTX) selectively targets the peripheral adverse effects of opioids while preserving the central analgesic effects of opioid agonist treatment.


METHODS
While it is indicated for use in nonsurgical patients in the palliative care setting, here we report the use of MNTX for the alleviation of postoperative ileus in a heroin user with recurrent cervical cancer undergoing diverting colostomy and urinary conduit placement.


CONCLUSIONS
Results suggest that MNTX may accelerate postoperative gastrointestinal recovery in opioid-dependent patients. Further studies are warranted to evaluate its role in the pharmacologic management of postoperative ileus.
Ladanyi
Andras
A
Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA.
Temkin
Sarah M
SM
Moss
Jonathan
J
D000701:Analgesics, Opioid / Q000009:adverse effects*; D005260:Female; D006556:Heroin Dependence / Q000150:complications; D006801:Humans; D045823:Ileus / Q000139:chemically induced / Q000188:drug therapy*; D007279:Injections, Subcutaneous; D008875:Middle Aged; D009271:Naltrexone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D000644:Quaternary Ammonium Compounds; C032257:methylnaltrexone; D009271:Naltrexone