Post-abdominal surgery, gastrointestinal dysfunction may occur, with clinical manifestations including postoperative ileus (POI), abdominal distension, nausea and vomiting, delayed flatus and defecation, and food intolerance leading to delayed oral feeding.
Conditions
Interventions
Experimental group:Epidural infusion of hydromorphone
Sponsors
Zhejiang Cancer Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Age between 18 years and 80 years; 2. BMI ranging from 18.0 to 28.0; 3. Planned for abdominal gastrointestinal surgery (including laparoscopic or open surgery, excluding liver or pancreaticoduodenectomy, etc.), with an estimated operation time of >= 2 hours; 4. ASA classification of grades I to III; 5. Agree to use general anesthesia combined with epidural anesthesia; 6. No history of chronic pain or abuse of opioid drugs before the operation; 7. Sign the informed consent form.
Exclusion criteria
Exclusion criteria: 1.Severe underlying heart and lung diseases; 2) Previous central nervous system diseases, spinal deformities or injuries, history of spinal surgery, or abnormal coagulation function and other contraindications for epidural puncture; 3) Cognitive dysfunction, unable to cooperate with the study; 4) Uncontrolled mental system diseases or concurrent severe neuromuscular diseases (such as myasthenia gravis); 5) Allergy to opioids and any drugs involved in the study; 6) Preoperative severe gastrointestinal dysfunction diseases, such as: chronic intestinal obstruction, inflammatory bowel disease (Crohn's disease, ulcerative colitis), advanced liver cirrhosis with intractable ascites, or a history of major gastrointestinal surgery; 7) Long-term use of drugs that seriously affect gastrointestinal motility before surgery (such as: long-term use of laxatives, anticholinergic drugs, GLP-1 receptor agonists, etc.); 8) Severe liver and kidney dysfunction (Child-Pugh C grade or eGFR < 30 ml/min/1.73m^2).9)Pregnant or lactating women.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| rate of return of gut function at 72 hours after surgery measured by GI-3 recovery; | — |
Secondary
| Measure | Time frame |
|---|---|
| I-FEED Score;Total perioperative opioid consumption (up to 72 hours);time to GI-3 recovery;Time to GI-2 recovery;Incidence of Perioperative Complications;Quality of Recovery–15 score; | — |
Countries
China
Contacts
Public ContactXu Pingbo
Zhejiang Cancer Hospital
Outcome results
None listed