Post Op Ileus prevention

Ambulation: early and often.

That and, keep npo longer for surgeries like gyne, eg. gyne lap with extensive endometriosis excision, etc. Lots of bowel manipulation there and lots trouble avoided if outpatients were told to hold off for longer, then start with liquids, etc.

Reglan, but only with specific types of bowel surgeries. With a stunned gut, reglan causes more harm, simply put (it's more extensive, you'll need to speak with surgeons as to why they prescribe it and when). Ambulation, advancing to clears ASAP per MD. Knowing to medicate for pain 30 minutes to a PO dose prior to ambulation and NEVER taking "no" for an answer unless hemodynamically unstable.

Our post open hearts are out of bed a MINIMUM of 4 hours after extubation, if stable and on minimal drips one hour after extubation, swanned, on drips they are in the chair, period. Our only Illeus issues are our very sick and unstable post ops where vasopressers have decreased blood flow to the gut and issues like that.

Move 'em quick and early and keep 'em moving.

Anyone heard of using chewing gum? We have one surgeon who always orders his post-op bowel patients to chew gum.

Epidurals have been shown to help with quicker return of bowel function/post-op ileus. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116422/

Lidocaine gtts during surgery have also been shown to help return bowel function quicker and have results comparable to epidurals. http://www.ncbi.nlm.nih.gov/pubmed/20518581