Gastrointestinal prokinetics'efficiency and risk factors of development of postoperative ileus: clinical study. | Efficacité des procinétiques gastro intestinaux et facteurs de risque de développement de l'iléus postoperatoire: étude clinique.

Because of the lack of clinical data in the area, this clinical study was performed to evaluate gastrointestinal prokinetics’ efficiency. Material used includes 2 groups composed each one by 25 horses which underwent surgery for small intestinal lesions in the University of Liège between january 1997 and august 2005. The 2 groups were formed by a selection resulting in similar (or not significantly different) mean values for the age, gravity score, shock score, packed cell volume on admission in the clinic and length of resected intestine when an enterectomy was performed. Between the 2 groups, we searched also equal (or not significantly different) proportions of Belgian Warmblood, of females/males, of horses wich underwent an enterectomy, of horses which had a concomitant lesion of the large intestine and of horses wich needed 1 or more sedative α2 agonist drug during the postoperative period. One group was treated with gastrointestinal prokinetics (lidocaine, erythromycin, metoclopramide) systematically, whereas the other one not and the incidence and duration of postoperative ileus was evaluated. No significant difference in the incidence or the duration of postoperative ileus was found between the 2 groups. Because our results did not show any effect of prokinetics, a statistical analysis searched in these 50 horses the risk factors of postoperative ileus among the following parameters: breed, age, sex, gravity score, shock score, packed cell volume on admission in the clinic, protocol of induction of anaesthesia, duration of anaesthesia, performing an enterectomy and length of the resected intestine, concomitant lesion of the large intestine, and administration of sedative α2 agonists during the postoperative period. Only the Belgian warmblood breed and the administration of sedative α2 agonist drugs after the recovery from anaesthesia were significantly more important in the group where horses developed a postoperative ileus. Undoubdtedly, this study includes only 50 cases selected for the homogeneity of their parameters and not all the cases of small intestine surgery during the test period. In view of these results, it would be interesting performing this study again on a larger number of cases in a prospective manner.