Abstract
Post-operative ileus (POI) is a frequent complication after abdominal
surgery. The consequences of POI can be potentially serious such as
bronchial inhalation or acute functional renal failure. Numerous
advances in peri-operative management, particularly early
rehabilitation, have made it possible to decrease POI. Despite this, the
rate of prolonged POI ileus remains high and can be as high as 25% of
patients in colorectal surgery. From a pathophysiological point of view,
POI has two phases, an early neurological phase and a later inflammatory
phase, to which we could add a “pharmacological” phase during which
analgesic drugs, particularly opiates, play a central role. The aim of
this review article is to describe the phases of the pathophysiology of
POI, to analyse the pharmacological treatments currently available
through published clinical trials and finally to discuss the different
research areas for potential pharmacological targets.