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Surgeons' Cancer
Subcutaneous Methylnaltrexone to Restore Postoperative Bowel Function in a Long-Term Opiate User
  1. Andras Ladanyi, MD, PhD*,
  2. Sarah M. Temkin, MD† and
  3. Jonathan Moss, MD, PhD‡
  1. *Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL;
  2. †University of Maryland Women's Health, Baltimore, MD; and
  3. ‡Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.
  1. Address correspondence and reprint requests to Sarah M. Temkin, MD, University of Maryland Women's Health, Third Floor, Stapa Bldg, 110 S Paca St, Baltimore, MD 21201. E-mail: stemkin{at}upi.maryland.edu.

Abstract

Introduction: One of the most common undesired effects of analgesic opioid use and addiction is constipation. Numerous pharmacologic agents have been used to treat opioid-induced bowel hypomotility with limited success. Methylnaltrexone bromide (MNTX) selectively targets the peripheral adverse effects of opioids while preserving the central analgesic effects of opioid agonist treatment.

Case: While it is indicated for use in nonsurgical patients in the palliative care setting, here we report the use of MNTX for the alleviation of postoperative ileus in a heroin user with recurrent cervical cancer undergoing diverting colostomy and urinary conduit placement.

Conclusions: Results suggest that MNTX may accelerate postoperative gastrointestinal recovery in opioid-dependent patients. Further studies are warranted to evaluate its role in the pharmacologic management of postoperative ileus.

  • Methylnaltrexone
  • Postoperative ileus
  • Cervical cancer

http://dx.doi.org/10.1111/IGC.0b013e3181cd1828

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    Footnotes

    • This study did not receive any financial support. Dr Jonathan Moss serves as a paid consultant to Progenics Pharmaceuticals, Inc, has a financial interest in methylnaltrexone bromide as a patent holder through the University of Chicago, and receives stock options from Progenics.