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document
Alvimopan for the management of postoperative ileus after bowel resection : characterization of clinical benefit by pooled responder analysis . BACKGROUND A pooled post hoc responder analysis was performed to assess the clinical benefit of alvimopan , a peripherally acting mu-opioid receptor ( PAM-OR ) antagonist , for the management of postoperative ileus after bowel resection . METHODS Adult patients who underwent laparotomy for bowel resection scheduled for opioid-based intravenous patient-controlled analgesia received oral alvimopan or placebo preoperatively and twice daily postoperatively until hospital discharge or for 7 postoperative days . The proportion of responders and numbers needed to treat ( NNT ) were examined on postoperative days ( POD ) 3-8 for GI-2 recovery ( first bowel movement , toleration of solid food ) and hospital discharge order ( DCO ) written . RESULTS Alvimopan significantly increased the proportion of patients with GI-2 recovery and DCO written by each POD ( P < 0.001 for all ) . More patients who received alvimopan achieved GI-2 recovery on or before POD 5 ( alvimopan , 80 % ; placebo , 66 % ) and DCO written before POD 7 ( alvimopan , 87 % ; placebo , 72 % ) , with corresponding NNTs equal to 7 . CONCLUSIONS On each POD analyzed , alvimopan significantly increased the proportion of patients who achieved GI-2 recovery and DCO written versus placebo and was associated with relatively low NNTs . The results of these analyses provide additional characterization and support for the overall clinical benefit of alvimopan in patients undergoing bowel resection .
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Intervention_Pharmacological
Alvimopan
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Intervention_Pharmacological
alvimopan
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Intervention_Surgical
laparotomy
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Intervention_Pharmacological
oral alvimopan
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Intervention_Control
placebo
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Intervention_Pharmacological
Alvimopan
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Intervention_Pharmacological
alvimopan
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Intervention_Pharmacological
alvimopan
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Intervention_Control
placebo
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Intervention_Pharmacological
alvimopan
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Intervention_Control
placebo
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Outcome_Physical
proportion of patients with GI-2 recovery and DCO written by each POD
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Outcome_Physical
GI-2 recovery
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Outcome_Physical
POD 5
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Outcome_Physical
GI-2 recovery