Format:
Online-Ressource
ISSN:
1877-8879
Content:
Background: Opioid analgesics inhibit anal sphincter function and contribute to opioid-induced bowel dysfunction. However, it is unknown if the inhibition can be reduced by opioid antagonism with oral naloxone, and how this compares to osmotic laxative treatment. Aims: To compare the effects of oxycodone and macrogol 3350 treatment (OX + PEG) versus combined oral oxycodone and naloxone (OXN) on anal sphincter function and gastrointestinal symptoms. Methods: A randomised, double-blind, crossover trial was conducted in 20 healthy, male volunteers. Participants were randomised to five days treatment of OX + PEG or OXN. Anal resting pressure, anal canal distensibility, and rectoanal inhibitory reflex-induced sphincter relaxation were evaluated at baseline and on day 5. The Patient Assessment of Constipation questionnaire (PAC-SYM), stool frequency, and stool consistency were assed daily. Results: Sphincter relaxation was reduced after OX + PEG treatment compared to OXN (difference = −17.6% [95% Cl;−25.2, −10.2]; P 〈 0.001). Anal resting pressure and anal canal distensibility did not differ between the treatments. PAC-SYM abdominal symptom subscale increased during OX + PEG compared to OXN (cumulated score: 3.2±2.3 vs. 0.2±1.8; P =0.002). Number of bowel movements was higher during OX + PEG vs. OXN (5.4±1.5 vs. 4.2±1.2; P = 0.035), but there was no difference in stool consistency (3.5±0.5 vs. 3.2±0.4; P = 0.14). Conclusions: Sphincter relaxation was significantly reduced after OX + PEG compared to OXN. Evaluation of the rectoanal inhibitory reflex may serve as an important objective measure in future trials on treatment of opioid-induced bowel dysfunction.
In:
volume:16
In:
number:1
In:
year:2017
In:
pages:179-179
In:
extent:1
In:
Scandinavian journal of pain, Berlin : De Gruyter, 2009-, 16, Heft 1 (2017), 179-179 (gesamt 1), 1877-8879
Language:
English
DOI:
10.1016/j.sjpain.2017.04.043
URN:
urn:nbn:de:101:1-2024022714205178228034
URL:
https://doi.org/10.1016/j.sjpain.2017.04.043
URL:
https://nbn-resolving.org/urn:nbn:de:101:1-2024022714205178228034
URL:
https://d-nb.info/1321842430/34