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April 9, 1938

MANAGEMENT OF POSTOPERATIVE DISTENTION AND ILEUS: THE USE OF PROSTIGMINE IN 175 CASES OF ABDOMINAL SURGERY COMPLICATED BY PARALYTIC ILEUS AND POST-OPERATIVE DISTENTION

Author Affiliations

Attending Surgeon, Cook County, Garfield Park and Illinois Masonic Hospitals; Resident Surgeon, Cook County Hospital CHICAGO

From the Cook County Hospital.

JAMA. 1938;110(15):1165-1168. doi:10.1001/jama.1938.02790150011004
Abstract

One of the grave postoperative complications is intestinal atony. The paralysis and distention accompanying intestinal atony contributes materially to the mortality of diffuse peritonitis. The patient's dread of abdominal surgery is deeply tinctured by fear of "gas pains," which are familiar even to the general public as the prominent symptom of a distressing, distentionridden, postoperative course.

It is not surprising, therefore, that a wide variety of drugs, as well as a large number of mechanical procedures, have been developed to combat this unwelcome postoperative complication. One of these, physostigmine (eserine), was early used in the treatment of intestinal atony, but its stimulating action on the parasympathetic system may be evidenced not only by an increased intestinal peristalsis but also by bradycardia, dyspnea, miosis and a fall in blood pressure. Stedman and his co-workers,1 in their work on substances capable of inducing responses similar to those induced by physostigmine, investigated

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