Neostigmine for the treatment of pediatric acute colonic pseudo-obstruction
Child; Humans; Male; Risk Factors; Preschool; Cholinesterase Inhibitors/therapeutic use; Colonic Pseudo-Obstruction/drug therapy/etiology; Neostigmine/therapeutic use
Acute colonic pseudo-obstruction (ie, Ogilvie's syndrome) is an uncommon but serious condition in the pediatric population. Definitive management traditionally has consisted of endoscopic decompression. Recent studies have documented the effectiveness of neostigmine as a pharmacologic alternative to mechanical decompression. To date, however, this literature has focused exclusively on the adult population. The authors present the first reported case of the successful administration of neostigmine to treat acute colonic pseudo-obstruction in a child.
2002
Gmora S; Poenaru D; Tsai E
Journal Of Pediatric Surgery
2002
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1053/jpsu.2002.35438" target="_blank" rel="noreferrer">10.1053/jpsu.2002.35438</a>
Neostigmine increases postoperative colonic motility in patients undergoing colorectal surgery
Female; Humans; Male; Adult; Aged; Middle Aged; Reference Values; Injections; Intravenous; Nutritional Failure; Manometry; Cholinesterase Inhibitors/therapeutic use; Neostigmine/therapeutic use; Colon/drug effects/physiopathology/surgery; Gastrointestinal Motility/drug effects; Postoperative Care; Rectum/surgery
BACKGROUND: Gastrointestinal motility is frequently impaired after abdominal surgery. We investigated the effects of neostigmine on colonic motility in patients after colorectal surgery and in healthy volunteers. METHODS: Colonic motility was recorded by a manometry/barostat system in 12 patients after left colonic or rectal resection during baseline and after the intravenous administration of increasing doses of neostigmine on postoperative days 1, 2, and 3. In addition, colonic motility was recorded in 7 healthy volunteers. RESULTS: Neostigmine increased the colonic motility index. This increase was from 135 +/- 28 mm Hg/min at baseline to 574 +/- 219 mm Hg/min after administration of 5 microg/kg neostigmine on day 3 after surgery (mean +/- SEM, P <.05). In healthy volunteers, neostigmine at a dose of 5 microg/kg increased the colonic motility index from 184 +/- 73 to 446 +/- 114 mm Hg/min (P <.05). Barostat bag volumes decreased dose-dependently after neostigmine administration in patients as well as in volunteers, indicating an increase in colonic tone. CONCLUSIONS: Colonic motility and tone increased after neostigmine administration at a dose of 5 microg/kg in postoperative patients and in healthy volunteers. Neostigmine can be used to stimulate colonic motility after colorectal surgery and has a similar effect postoperatively as in healthy volunteers.
2001
Kreis ME; Kasparek M; Zittel TT; Becker HD; Jehle EC
Surgery
2001
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1067/msy.2001.116451" target="_blank" rel="noreferrer">10.1067/msy.2001.116451</a>