Matthew B. Burruss, Bryan A. Ehlert, Timothy W. Capps, William M. Bogey, Frank M. Parker, Charles S. Powell, Michael C. Stoner
East Carolina University Heart Institute, Brody SOM, Greenville, NC.
OBJECTIVES: Alvimopan is a peripherally acting mu-opioid antagonist used to shorten the time to return of gastrointestinal function after surgery. Randomized clinical trials have demonstrated a shorter time period to return of bowel function and discharge in open abdominal colonic surgeries, but no data exists on its use in the aortic vascular surgery population.
METHODS: Alvimopan was administered to patients having open abdominal aortic aneurysm repair or aortofemoral bypass. The administration protocol was one 12 mg dose preoperatively and doses of 12 mg twice a day postoperatively until the first bowel movement or a total of seven days. There were seven patients in the study group and 6 patients in the control group. The primary end points were time to regain bowel function and length of hospital stay.
RESULTS: The average age (Study=69.3±3.8 years vs. Control=68.5±3.4 years; p=0.88), abdominal aortic aneurysm size (Study=5.9±0.3 cm vs. Control=5.3±0.5 cm; p= 0.28), procedure time (Study=2.1±0.1 hours vs. Control=2.6±0.3 hours; p=0.12), gender and comorbidities were not different between the two cohorts. There is a quicker time to regain bowel function (Study =2.9±0.4 days vs. Control=4.5±0.6 days; p= 0.04) and shorter hospitalization (Study=5.6±0.3 days vs. Control=6.8±0.4 days; p= 0.03) in the study group compared to the control group.
CONCLUSIONS: These preliminary data show that perioperative Alvimopan benefits patients, resulting in quicker time to regain bowel function and shorter hospitalization, consistent with previous studies involving open abdominal bowel resection. This improved resource utilization supports further investigation via a large scale randomized pharmacoeconomic endpoint trial.
AUTHOR DISCLOSURES: W. M. Bogey, Nothing to disclose; M. B. Burruss, Nothing to disclose; T. W. Capps, Nothing to disclose; B. A. Ehlert, Nothing to disclose; F. M. Parker, Nothing to disclose; C. S. Powell, Nothing to disclose; M. C. Stoner, Nothing to disclose.
Posted April 2012