Evaluation of neostigmin for the stimulation of postoperative colonic motility. Combined manometry/barostat recordings in patients.

Background: It is desirable to stimulate postoperative colonic motility whi ch is inhibited following abdominal surgery. The aim of the present study w as to evaluate the effects of neostigmin on postoperative colonic motility. Methods: In 12 patients undergoing colorectal procedures, a combined manome try/barostat catheter was placed into the colon intraoperatively. From day 1 to day 3 after surgery, colonic motility was recorded at baseline and fol lowing 0.05, 0.5 and 5 mu g/kg body weight neostigmin which was administere d i.v. over a 10 minute period. Results: During all postoperative days the colonic motility index was incre ased following 5 mu g/kg neostigmin. At day 3, a dose of 0.5 mu g/kg was al so sufficient to stimulate colonic motility. Barostat bag volumes decreased dose-dependendly following neostigmin infusion, indicating increased colon ic tone. Neostigmin stimulates postoperative colonic motility and causes an increase in colonic tone. Conclusion: Administration of neostigmin appears to be useful for the treat ment of postoperative colonic ileus.