Neostigmine for acute colonic pseudo-obstruction: A meta-analysis

INTRODUCTION: Acute colonic pseudo-obstruction (ACPO) is an uncommon condition that occasionally develops in hospitalized patients with serious underlying ailments. Its early recognition is essential to reduce life-threatening complications. Few low-powered randomized clinical trials (RCTs) have con...

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Detalles Bibliográficos
Autores principales: Valle, Raul Guillermo Lopez, Godoy, Francisco Lopez
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Review
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284455/
https://www.ncbi.nlm.nih.gov/pubmed/25568788
http://dx.doi.org/10.1016/j.amsu.2014.04.002
Descripción
Sumario:INTRODUCTION: Acute colonic pseudo-obstruction (ACPO) is an uncommon condition that occasionally develops in hospitalized patients with serious underlying ailments. Its early recognition is essential to reduce life-threatening complications. Few low-powered randomized clinical trials (RCTs) have confirmed the effectiveness of neostigmine for treatment. AIM: To analyse the effectiveness and main side effects of neostigmine in the treatment of ACPO. EXPERIMENTAL: A literature search was performed for all published RCTs, reporting on neostigmine as treatment for ACPO. RESULTS: Four studies fulfilled the inclusion criteria, evaluating 127 patients: treatment group = 65, control group = 62. Neostigmine effectiveness to resolve ACPO with only one dose was 89.2% versus 14.65% (P < 0.001, NNT = 1 [95% CI 1–2]). CONCLUSIONS: Neostigmine is a safe and effective option for patients with ACPO who failed to respond to conservative management.

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