Alvimopan Use in Polytraumatized Patients

A Double Blind, Randomized, Parallel Design Study to Evaluate the Effectiveness of Post-operative Dose of Alvimopan(Entereg) in Preventing Post-operative Ileus in Poly-traumatized Patients

To evaluate the efficacy and safety of Alvimopan(12 mg) in recovery of bowel function in an emergency trauma setting without the pre-operative dosage in patients that will receive abdominal surgery.

Inclusion Criteria:

• Ages 18 to 80
• Poly-traumatized patients
• Extubated patients after abdominal exploration
• Underwent Abdominal exploration, had colon resection with primary anastomosis with closure of abdomen

Exclusion Criteria:

• Mechanically ventilated patients
• Patient not expected to survive Glasgow Coma Scale = 3
• Pregnant patients
• Apache score > 40 (observed mortality 100%) Saas Ahmed Naved et al 2011
• Vasopressor therapy
• Septic patients
• Thoracotomy
• Bogota bag
• Intravenous Drug Abuser (IVDA) as evidenced by urine toxicology upon admission to the Trauma Unit
• Patients with prior history of gastric surgery and/or colonic surgery
• Medical History: of severe cardiovascular disease, Renal diseases, Hepatitis C or Hepatic failure, Autoimmune disease, Crohn and Ulcerative Colitis (In view of the inflammation in the intestinal mucosal which may decrease optimal absorption of the medication) and or bowel obstruction
• Prior pancreatic anastomosis or gastric anastomosis; ostomy formation
• Chronic use of nonsteroidal anti-inflammatory drugs