Ileus primary prevention

Effective measures for the primary prevention of ileus include early mobilization, avoidance of Ryle’s tube (nasogastric tube), prior oral feeding with high carbohydrate solid or liquid solution, limiting parenteral fluids, avoidance of pain medications such as opiates, utilizing a minimally invasive surgical method and use of epidural anesthesia for postoperative analgesia.

Effective measures for the primary prevention of ileus include:^[1][2][3][4]

• Early mobilization
• Avoid routine insertion of Ryle’s tube (nasogastric tube)
• Prior oral feeding with high carbohydrate solid or liquid solution (preferably six hours prior to surgery)
• Administration of clear fluids within 2-3 hours of surgery
• Limited parenteral fluids
• Utilizing a minimally invasive surgical method if possible
• Avoidance of pain medications such as opiates
• Epidural catheter (spinal anesthesia) for postoperative analgesia
• Postoperative gum chewing, which may increases the intestinal peristalsis due to the cephalovagal reflex and inflammation (level Ia evidence)

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