International Medical Journal, Vol. 24., Iss. 1, 2018, P. 43−46.
PREVENTION OF POSTOPERATIVE INTESTINAL PARESIS AFTER COLON SURGERY
Kharkiv National Medical University
V. T. Zaitsev Institute of General and Emergency Surgery NAMS of Ukraine, Ukraine
Disorders of motor−evacuation function of the intestine are found not only after emergency, but also after planned and even small in volume abdominal interventions performed by laparoscopic access. Traditional operations in diseases of the colon tend to lead to prolonged intestinal paresis in the early postoperative period and development of a commissural disease due to trauma. Postoperative paresis should be considered at disorders of the evacuation of colon contents due to inhibition of the motor activity results in development of intestinal paresis and, as a consequence, the delay in the passage of intestinal contents, intensive growth and changes in the microflora of the small intestine. Under the conditions of the peritoneum inflammation, imbalance between different types of microorganisms and their distribution in different parts of the intestine develop. All these suggest of the necessity of measures to prevent intestinal paresis. The results of treatment of patients who underwent obstructive and reconstructive−reconstructive operations on the colon were analyzed to determine the efficacy of such measures. Some patients underwent traditional analgesic, infusion and prokinetic therapy during the operation and in the immediate postoperative period, while the others were administered benzohexonium at a dose of 0.12 mg/kg intravenously as a component of the neurovegetative blockade during the surgery (10−15 min after anesthesia) by means of tachyphylaxis, and 6 hours after the operation −− 0.12−0.15 mg/kg intramuscularly with narcotic and non−narcotic analgesics. The proposed program for prevention and treatment of gastrointestinal paresis after surgery on the colon can reduce the tone of the sympathetic nervous system, promote early recovery of digestive functions and prevents development of complications.
Key words: intestinal paresis, colon surgery, prevention.