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John Lemmo, PA
Joint Implant Surgeons, Inc

John Karnes, BSN, CRNA
St Anthony Hospital Columbus, Ohio

JAMA. 1985;254(13):1721.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In reference to the article by Chen et al¹ we have had a similar experience with adynamic ileus following deliberate hypotensive anesthesia. We discovered the condition to be most prevalent with a balanced anesthesia technique using sufentanil (1 µg/kg) with isoflurane (0.5% to 1% concentrations with 50% nitrous oxide and oxygen combination). The postoperative pain medication protocol was morphine sulfate (5 to 10 mg) with hydroxyzine (Vistaril) (25 to 50 mg) every two to four hours. Our investigation revealed that six of 20 patients developed adynamic ileus postoperatively. Upon reviewing the literature, we feel that our experience was similar to that described as "narcotic bowel syndrome" by Sandgren et al.² The syndrome occurs two to four days postoperatively, with the cessation of the narcotic treatment. By switching from sufentanil to fentanyl we have eliminated this syndrome. . . . [Full Text PDF of this Article]

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