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The Efficacy Of Peripheral Opioid Antagonists In Opioid-Induced Constipation And Postoperative Ileus: A Systematic Review Of The Literature., Eric S. Schwenk, Alexander E. Grant, Marc C. Torjman, Stephen E. Mcnulty, Jaime L. Baratta, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

Opioid-induced constipation has a negative impact on quality of life for patients with chronic pain and can affect more than a third of patients. A related but separate entity is postoperative ileus, which is an abnormal pattern of gastrointestinal motility after surgery. Nonselective μ-opioid receptor antagonists reverse constipation and opioid-induced ileus but cross the blood-brain barrier and may reverse analgesia. Peripherally acting μ-opioid receptor antagonists target the μ-opioid receptor without reversing analgesia. Three such agents are US Food and Drug Administration approved. We reviewed the literature for randomized controlled trials that studied the efficacy of alvimopan, methylnaltrexone, and naloxegol in …