ceruletide and Intestinal-Obstruction

Sequential analysis of a double-blind clinical trial involving 26 patients demonstrated a statistically significant superiority of ceruletide over metroclopramide in restoring peristalsis in intestinal paralysis after abdominal surgery (P less than 0.05).

Topics: Adult; Aged; Ceruletide; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Male; Metoclopramide; Middle Aged; Postoperative Complications

We conducted a controlled clinical trial designed to test caerulein for tolerability and effectiveness in post-operative patients recovering from abdominal surgery. The test product was administered 24 hours after surgery, by intravenous drip infusion, at the rate of 2 nanograms/kg/minute. The results were compared with parallel observations made in a matched group of patients receiving no drugs or manipulation likely to promote intestinal peristalsis with the exception of the application of a nasogastric tube for aspiration and the water and electrolyte replenishment customary in the post-operative period. The results of this study evince a clear-cut difference between the two groups of patients in regard to the restoration of intestinal peristalsis and the passing of flatus and faeces, as confirmed by statistical analysis (Cochran's test) demonstrating the significant (p less than 0.01) superiority of caerulein treatment relative to the untreated control group. Likewise, the study revealed the excellent tolerability of the test drug at the dosage employed.

Topics: Ceruletide; Female; Humans; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Laparotomy; Male; Peristalsis; Postoperative Complications

Topics: Biliary Tract; Ceruletide; Clinical Trials as Topic; Constipation; Gastrointestinal Motility; Humans; Intestinal Obstruction; Megacolon

Gastrointestinal mechanical activity was studied in 13 patients after different surgical procedures in a fasted and fed state and after pharmacological stimulation. Mechanical activity was recorded by means of a multi-pressure sensor probe placed intraoperatively into the jejunum. Abdominal surgery abolished normal motility only for a short period of time. The time for the reappearance of regular recurring activity fronts varied with the type of the surgical procedure from 3 hr after cholecystectomy to the sixth postoperative day after colon resection. The fed pattern occurred after the first postoperative interdigestive motor complex in all experiments. Stimulation was observed with ceruletide, which induced contractile activity in the small intestine during postoperative ileus. No coordinated caudad propagating activity was observed. The postoperative interdigestive motor complex did not correlate in time with the first passage of flatus and stool in our patients. Thus, the restoration of motility in the small intestine did not coincide with the clinical relief from the so-called "physiological" postoperative ileus.

Topics: Aged; Ceruletide; Duodenal Diseases; Eating; Fasting; Female; Gastrointestinal Diseases; Gastrointestinal Motility; Humans; Ileal Diseases; Intestinal Obstruction; Jejunal Diseases; Male; Middle Aged; Postoperative Complications

Gastrointestinal myoelectrical activity was registered in 6 dogs after different surgical procedures such as laparotomy, segmental resection of the jejunum and right hemicolectomy. Animals were studied in the fasted- and fed state and after pharmacological stimulation with Ceruletide. The electrical activity was recorded by means of 6 bipolar electrodes implanted along the intestinal wall. Abdominal surgery abolished normal motility in the stomach and small intestine only for a short period of time. The time for the reappearance of regularly recurring activity fronts varied with the type of the surgical procedure from 3 h after segmental resection of the jejunum to 49 h after colon resection. Severe disturbances of the BER (basic electrical rhythm) in the stomach as tachygastria and tachyarrhythmia persist even after restoration of the MMC (migrating motor complex) in the small intestine. Feeding induced a typical fedpattern but never before restoration of the MMC. Stimulation of the intestine during postoperative ileus with Ceruletide increases segmental myoelectrical activity. The period of postoperative ileus was not reduced.

Topics: Animals; Ceruletide; Colectomy; Dogs; Electromyography; Evoked Potentials; Gastrointestinal Motility; Intestinal Obstruction; Intestine, Small; Muscle, Smooth; Postoperative Complications

The myoelectric activity of the small bowel was evaluated in 6 rabbits following 24 h of complete small-bowel obstruction and in 6 rabbits during an intra-abdominal perfusion with a bacterial suspension containing Bacteroides fragilis and Escherichia coli. Myoelectric recordings were performed before and during pharmacological small-bowel stimulation with ceruletide. Following small-bowel obstruction both slow-wave frequency and spike activity were reduced. Ceruletide stimulation demonstrated a significantly decreased spike activity after 24 h of obstruction. Intra-abdominal bacterial contamination did not affect spontaneous slow-wave frequency and spike activity but induced complete resistance to ceruletide stimulation. Pharmacological stimulation is recommended as an additional method to evaluate the impairment of myoelectric activity in motility disorders.

Topics: Abdomen; Animals; Bacteria; Bacteroides fragilis; Ceruletide; Electromyography; Escherichia coli; Female; Injections; Intestinal Obstruction; Intestine, Small; Male; Muscle, Smooth; Perfusion; Rabbits; Sodium Chloride

Topics: Auscultation; Ceruletide; Chlorpromazine; Dihydroergotamine; Gastrointestinal Motility; Humans; Infusions, Parenteral; Intestinal Obstruction; Sympatholytics; Trifluperidol

Intestinal stimulation is among the basic therapeutic procedures in functional ileus. But the majority of cases of functional ileus is due not to paralysis but to adrenergic inhibition. Thus the primary treatment should not be to stimulate but to act against the inhibition. In over 100 patients a combined treatment schedule consisted of primary adrenergic blockade (trifluperidol, dihydroergotamine or chlorpromazine) followed by low doses of stimulants (ceruletide, neostigmine). 52 patients who had not responded to high doses of peristalsis-stimulating drugs acted as their own controls: in 48 of them intestinal function was restored by sympathicolysis. If indications and application are properly observed the method has a low risk and provides effective treatment of functional ileus, especially in cases resistant to other forms of treatment.

Topics: Adolescent; Adult; Aged; Ceruletide; Child; Child, Preschool; Chlorpromazine; Dihydroergotamine; Female; Humans; Intestinal Obstruction; Male; Middle Aged; Neostigmine; Trifluperidol

Topics: Ceruletide; Humans; Intestinal Diseases; Intestinal Obstruction; Postoperative Complications

Three patients had as a side effect of cytostatic treatment severe intestinal atonia which in two cases led to paralytic ileus. With ceruletid (Takus) rapid normalisation of intestinal peristalsis was achieved in all three patients.

Topics: Adult; Bleomycin; Ceruletide; Humans; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Male; Vinblastine; Vincristine

Topics: Ceruletide; Humans; Intestinal Neoplasms; Intestinal Obstruction; Parasympathomimetics

After the failure of other medicamentous treatment attempts for paralytic ileus, Ceruletid (Takus) was used in 20 surgical patients. Ceruletid was applied as an infusion of 40 microgram in 250 ml or 500 ml physiological saline solution over a period of 2-3 hours. During this time the occurrence of bowel sounds, flatulence and defecation was observed. The most important clinical and serological parameters were measured before and after treatment. Treatment was successful in 17 cases, in 3 cases no success was achieved. Severe side effects did not occur. The use of Ceruletid in the described form of administration can be recommended for the treatment of paralytic ileus.

Topics: Ceruletide; Drug Evaluation; Humans; Infusions, Parenteral; Intestinal Obstruction; Intestinal Pseudo-Obstruction

After a short analysis of the pathogenetic causes which can lead to paralytic ileus and the drugs at present available for treatment of this serious morbid form, the paper reports results obtained with Ceruletide, a decapeptide which has proved active on intestinal peristalsis in experimental and clinical trials. The results of this study, carried out on 20 patients subjected to surgical operation on the abdomen, treated with Ceruletide by intramuscular route 24-48 hours after the operation, showed that this drug is capable of leading to a quick recovery of intestinal motor activity without causing the patient unpleasant effects for the patient. The practical utility of Ceruletide is evident since by leading to earlier canalisation of the intestine it also allows the venous hydro-electric delivery to be reduced, nasogastric aspiration to be eliminated early and hence the postoperative course to be made more acceptable to the patient.

Topics: Ceruletide; Female; Humans; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Male; Postoperative Complications

Topics: Auscultation; Ceruletide; Colon; Diagnosis, Differential; Female; Ganglia, Autonomic; Gastrointestinal Motility; Humans; Infant; Intestinal Obstruction; Megacolon; Radiography; Rectum