By M. Schemann, D. Reiche, M. Neunlist (auth.), Priv.-Doz. Dr. M. K. Herbert, Professor Dr. P. Holzer, Professor Dr. N. Roewer (eds.)

After a protracted interval of overlook, the gastrointestinal tract is more and more being recog­ nized as an incredible goal of anesthetics and anesthesia-related procedures, in addition to of stipulations and coverings with regards to peri- and postoperative interval and inten­ sive care. medicinal drugs utilized in anesthesia and in depth care and physiological or pathologi­ cal adjustments within the perioperative interval impact the digestive process in its functionality from the pharynx to the colon. lengthy postoperative ileus or stasis of propulsive peri­ stalsis within the seriously in poor health or multiply injured sufferer may possibly impair enteral foodstuff and provides upward push to problems corresponding to sepsis or a number of organ failure. In view of this new realizing of the medical relevance of intestine functionality, we felt publication on difficulties of the gastrointestinal tract in anesthesia, the perioperative interval, and in depth care used to be badly wanted. the current quantity is the fabricated from a global symposium which introduced jointly physiologists, pharmacologists, experimental and medical anesthetists, gastroenterologists, surgeons, and extensive care physicians to debate all significant modern features of bowel functionality in healthiness and lower than the impression of anesthesia, surgical procedure, and in depth care.

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Additional info for Problems of the Gastrointestinal Tract in Anesthesia, the Perioperative Period, and Intensive Care: International Symposium in Würzburg, Germany, 1-3 October 1998

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Conclusions Increased or decreased contractile activity does not necessarily lead to enhanced or decreased propulsion. The myenteric plexus, with its multiple transmitters and receptors, is a major target for compounds aimed at modifying GI motility. Although a variety of agents affect GI motility, only a few classes specifically interfere with contractile processes and their neuronal control mechanisms. These are: • Upper GI tract: Dz antagonists, 5-HT4 agonists or motilin agonists can be used to enhance, and calcium channel blockers, nitric oxide donors to reduce, motor activity.

The myenteric plexus, with its multiple transmitters and receptors, is a major target for compounds aimed at modifying GI motility. Although a variety of agents affect GI motility, only a few classes specifically interfere with contractile processes and their neuronal control mechanisms. These are: • Upper GI tract: Dz antagonists, 5-HT4 agonists or motilin agonists can be used to enhance, and calcium channel blockers, nitric oxide donors to reduce, motor activity. • Lower GI tract: 5-HT4 agonists can be used to enhance, and CCK antagonists, 5-HT 3 antagonists, opiate agonists and spasmolytics to reduce, motor activity.

Churchill Livingstone, Edinburgh Gianotti L, Alexander JW, Nelson JL, Fukushima R, Pyles T, Chalk CL (1994) Role of early enteral feeding and acute starvation on post burn bacterial translocation and host defense: Prospective, randomized trial. Crit Care Med 22: 265-272 Gottfried EM, Plumser AB (1984) Endoscopic gastrojejunostomy: A technique to establish small bowel feeding without laparotomy: Gastrointest Endosc 30: 355-357 Grahm TW, Zadrozny DB, Harrington T (1989) The benefits of early jejunal hyperalimentation in the head-injured patient.

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