A. A. Bohomolets National Medical University, Kyiv, De-partment of Faculty Surgery No. 1
The article presents a study of the impact of Sorbilact, solution for infusion, on peristalsis in the early postoperative period in coloproctological patients (24 persons) after abdominal surgical interventions. The results of the study indicate the positive impact of the drug product on the recovery of peristalsis, stabilization of the haemodynamics, and the absence of adverse effects. Sorbilact can be recommended in a comprehensive therapy scheme for coloproctological patients after abdominal surgical interventions.
Key words: coloproctology, propulsive bowel activity.
The proper maintenance of an early postoperative period is essential in the surgical treatment of patients who have undergone abdominal surgical intervention. In the therapeutic and prevention complex, the timely treatment of postoperative intestinal distention occupies a special place. Restoring the motor function of the intestine allows to start an early enteral feeding of a patient. This creates the conditions for a significant reduction in the daily infusion volume, which positively impacts the functional state of cardiovascular and breathing systems. Timely untreated postoperative intestinal distention aggravates the severe early postoperative period due to the occurrence of dyscrasia associated with hidden loss of water, electrolytes and proteins, which leads to the development of hypovolemic shock [2, 3]. Moreover, with a long “gas period” (distention of the large and small intestine loops), abdominal pressure is greatly increased, thus limiting the breathing excursion of the diaphragm. This affects the function of respiration, promotes the bronchial congestion and development of postoperative pneumonia.
The choice of medications that stimulate the motor function of the intestines that could be prescribed from days 1–2 after the surgery is quite limited. Cholinomimetics or other drugs with the similar mechanism of action (aceclidine, proserine, cerucal, ubretid, etc.) are used; however, they are not only inefficient when prescribed in early terms, but also may cause adverse reactions, therefore, they are usually prescribed from day 4–5, when the signs of postoperative intestinal distention are already developed in patients. Today, the Lviv Scientific Research Institute of Blood Pathology and Transfusion Medicine has developed a new drug product – Sorbilact solution, the main active pharmaceutical ingredients of which are sorbitol and sodium lactate. Hyperten-sive solution of sorbitol contained in Sorbilact has an expressed stimulating action on the smooth muscles of the intestine [1, 2, 5, 6]. This effect is due to the central mechanism as well as to the impact on the local nerve, hormonal and muscle structures of the intestine wall [2, 3]. In addition, Sorbilact, when introduced in the bloodstream, effectively increases the blood flow in mesentery of the large and small intestines [2, 4], quickly increases the plasma colloid osmotic pressure, normalizes the blood rheology, restores the microcirculation, and has an antishock, detoxification, diuretic and energy action. Sorbilact can be administered from the first hours after the surgical intervention and even at the time of surgery. The purpose of this study was to examine the impact of Sorbilact on the restoration of the intestinal motility in coloproctological patients who have undergone abdominal surgical intervention.