Pathophysiology of equine postoperative ileus: Effect of adrenergic blockade, parasympathetic stimulation and metoclopramide in an experimental model



An experimental model of postoperative ileus was developed in ponies using trauma to, and exposure of, a length of small intestine which gave rise to a reproducible and reversible set of changes in gut activity. This was assessed by recordings of electrical and mechanical activity and by propulsion of spheres from stomach to anus. Activity was depressed, especially in the stomach and colon, and transit was slowed. All drugs given increased electromechanical activity but propranolol was the least effective and did not alter the delayed transit of spheres. Yohimbine was more effective and the addition of bethanechol produced a little extra propulsive action. Metoclopramide had the best effect, virtually returning transit to normal and was the only drug fully restoring coordination of gastric and small intestinal activity which was disrupted by the ileus procedure. Loss of gastroduodenal coordination is probably the central lesion in equine ileus and may be mediated by dopamine.