Prophylactic Effect of oral Methylnaltroxane on Post Hysterectomy Bowel Motility: A Pilot Study

Opioids that are used during anesthesia may prolongate intestinal peristalsis. This study aimed to examine the effect of oral methylnaltrexone (OMNTX) on ileus after hysterectomy.

This study was performed as a randomized, double-blind screening for an elective abdominal hysterectomy at Alzahra Hospital in Rasht, Iran; 33 patients were assigned to the OMNTX group (25 mg) and 33 to the placebo group using the random block method. Patients were asked and recorded about gas passing, constipation, vomiting, itching, and urinary retention.

There was a significant difference in the meantime of initiation of intestinal sound (P=0.039) and constipation (P=0.62) between the two groups. There was a positive correlation coefficient in the placebo group (P=0.02) between the hours of surgery and the time of initiation of bowel movements after the surgery. Still, there was not in the OMNTX group (P=0.0001). The mean onset of bowel sounds after the surgery was not related to age (P=0.599) and the duration of surgery significantly (P=0.926).

It is possible that OMNTX before the surgery can trigger bowel sounds sooner after the surgery and prevent ileus.