EFFICACY OF METOCLOPRAMIDE FOR TREATMENT OF ILEUS IN HORSES FOLLOWINGSMALL-INTESTINAL SURGERY - 70 CASES (1989-1992)

In this retrospective study, postoperative ileus Mas studied in horses having resection of the small intestine followed by a jejunojejunal ( n=35) or a jejunocaecal (n=35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intr avenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour), Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P < 0.001), sh orter duration (P < 0.001), and a slower rate (P < 0.001) of postopera tive gastric reflux, and a shorter postoperative hospital stay (P < 0. 01) when compared to horses receiving no metoclopramide and horses rec eiving metoclopramide as an intermittent infusion. Horses having jejun ocarcostomy performed had a larger volume (P < 0.05), longer duration (P < 0.05), and a greater rate (P < 0.05) of postoperative gastric ref lux, and a longer postoperative hospital stay (P < 0.001) than horses undergoing jejunojejunostomy; Horses that had an abdominal drain place d during surgery had a longer length of intestine resected (P < 0,05) and a longer postoperative hospital stay (I)< 0.05) than horses withou t an abdominal drain. Horses that died or were euthanased during the p ostoperative period had a greater total volume (P < 0.05), longer dura tion (P < 0.05), and greater rate of postoperative gastric reflux (P < 0.01), a longer length of small intestine resected (P < 0.01), and a shorter postoperative hospital stay (P < 0.05) than horses that surviv ed until discharge From the hospital, In a multivariate regression ana lysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P < 0.0 01; r(2) = 0.24), duration (P < 0.001; r(2) = 0.24) and rate (P < 0.00 1; r(2) = 0.25) of postoperative gastric reflux. We concluded that met oclopramide given as a continuous intravenous infusion decreased the i ncidence and severity of ileus following small intestinal resection an d anastomosis in horses.