CISAPRIDE REDUCES NEONATAL POSTOPERATIVE ILEUS - RANDOMIZED PLACEBO-CONTROLLED TRIAL

Aim - To assess the efficacy of cisapride in reducing ileus persisting to the tenth postoperative day after neonatal abdominal surgery. Meth ods - A prospective, randomised, double blind trial comparing rectal c isapride (1.4-2.3 mg/kg/day) with placebo over sewn days was undertake n in 33 neonates. Results - Seven of 12 (58%) patients receiving place bo and eight of 11 (73%) receiving cisapride achieved a first sustaine d feed during treatment. Of those receiving cisapride, the first susta ined feed occurred at 2.3 days (SEM 0.6) compared with 4.7 days (SEM 0 .8) with placebo. By the seventh day the mean daily net enteral balanc e was 69 (SEM 18) ml/kg in the cisapride subgroup and 17 (SEM 8) ml/kg for those receiving placebo. Stool was passed on 6.3 (SEM 0.4) treatm ent days in the cisapride subgroup compared with 4.1 (SEM 1.0) treatme nt days in the placebo subgroup. Conclusion - Cisapride is effective i n neonates with a prolonged ileus after abdominal surgery.