Postoperative ileus is a transient cessation of bowel motility that occurs after bowel resection.
Alvimopan is a peripherally acting µ-opioid receptor antagonist.
Dr Anthony Senagore and colleagues from Michigan found that alvimopan accelerated gastrointestinal (GI) recovery in 5 randomized, double-blind, phase 3 postoperative ileus trials.
|Alvimopan accelerated GI recovery by 12 to 17 hours|
The team assessed patients who underwent open laparotomy for bowel resection in the absence of epidural anesthesia and received alvimopan (12 mg) or placebo.
The team evaluated individual covariates separately using Cox proportional hazards models that included the main effects of treatment and covariate factor.
The research team assessed time-to-gastrointestinal recovery, that is first toleration of solid food and first bowel movement or flatus.
The team also assessed first toleration of solid food and first bowel movement.
The researchers found that age over 65 years, male, and nonwhite patients achieved gastrointestinal recovery later than younger, female, and white patients.
Overall, alvimopan accelerated gastrointestinal recovery by 12 to 17 hours compared with placebo.
Within subgroups, regardless of covariate effect, patients who received alvimopan achieved gastrointestinal recovery sooner than patients who received placebo.
Dr Senagore's team concluded, "These post hoc analyses support that alvimopan accelerates gastrointestinal recovery across various patient populations."