title: Paralytic Ileus and Prophylactic Gastrointestinal Motility Medication after Spinal Operation.
abstract: OBJECTIVE
  To investigate the prevalence of paralytic ileus after spinal operation in the supine or prone operative position and to determine the efficacy of prophylactic gastrointestinal motility medications in preventing symptomatic paralytic ileus after a spinal operation.
  
  
  METHODS
  All patients received spinal surgery in the supine or prone operative position. The study period was divided into two phases: first, to analyze the prevalence of radiographic and symptomatic paralytic ileus after a spinal operation, and second, to determine the therapeutic effects of prophylactic gastrointestinal motility medications (postoperative intravenous injection of scopolamine butylbromide and metoclopramide hydrochloride) on symptomatic paralytic ileus after a spinal operation.
  
  
  RESULTS
  Basic demographic data were not different. In the first phase of this study, 27 patients (32.9%) with radiographic paralytic ileus and 11 patients (13.4%) with symptomatic paralytic ileus were observed. Radiographic paralytic ileus was more often noted in patients who underwent an operation in the prone position (p=0.044); whereas the occurrence of symptomatic paralytic ileus was not different between the supine and prone positioned patients (p=0.385). In the second phase, prophylactic medications were shown to be ineffective in preventing symptomatic paralytic ileus after spinal surgery [symptomatic paralytic ileus was observed in 11.1% (4/36) with prophylactic medication and 16.7% (5/30) with a placebo, p=0.513].
  
  
  CONCLUSIONS
  Spinal surgery in the prone position was shown to increase the likelihood of radiographic paralytic ileus occurrence, but not symptomatic paralytic ileus. Unfortunately, the prophylactic medications to prevent symptomatic paralytic ileus after spine surgery were shown to be ineffective.
authors.affiliation: Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Gyu Yeul
authors.initials: GY
authors.lastname: Ji
authors.affiliation: Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea. nsyoon@gmail.com.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea.
authors.forename: Dongkeun
authors.initials: D
authors.lastname: Hyun
authors.affiliation: Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea.
authors.forename: Hyeong-chun
authors.initials: HC
authors.lastname: Park
authors.affiliation: Department of Radiology, Inha University College of Medicine, Incheon, Korea.
authors.forename: Yeo Ju
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage* / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007275:Injections, Intravenous; D007418:Intestinal Pseudo-Obstruction / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage* / Q000494:pharmacology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D016684:Prone Position; D011446:Prospective Studies; D011859:Radiography; D056910:Republic of Korea; D012601:Scopolamine / Q000008:administration & dosage* / Q000494:pharmacology*; D013123:Spinal Fusion / Q000009:adverse effects*; D016683:Supine Position; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D000932:Antiemetics; D012601:Scopolamine; D008787:Metoclopramide
keywords: Spine surgery; paralytic ileus; position; prone; supine