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Keywords:

  • postoperative paralytic ileus;
  • prolonged postoperative ileus;
  • opioids

Abstract

Purpose

To determine the association between opioid use and the occurrence of postoperative paralytic ileus (POI) after different types of surgery.

Methods

The PHARMO database was used to perform a case control study in which intramural drug utilisation data were linked to hospital discharge diagnoses. All patients admitted for digestive, abdominal or genito-urinary surgeries were selected in 1998–2003. Cases with coded POI (ICD-9-CM 560.1 and 564.4) and controls with no POI were matched 1:10. The association between coded POI and opioid use was assessed using conditional logistic regression.

Results

In 0.2% of all admissions (total of 180,279), patients developed POI and in 18% of all admissions, patients received opioids. Three hundred and sixty-six cases with POI were selected with their matching controls. The use of (nico)morphine was associated with the risk for developing POI (odds ratio (OR) 12.1, 95% confidence interval (CI) 5.4–27.1). The association between opioids and POI was most obvious in patients with abdominal surgery (OR 33.8, 95%CI 6.2–184.6) and patients without colon/colorectal/rectal tumours (OR 13.2, 95%CI 5.7–30.3).

Conclusion

This study demonstrated a distinct association between the use of opioids, in particular natural opium alkaloids, and the risk for coded POI. Copyright © 2006 John Wiley & Sons, Ltd.