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BJA Advance Access originally published online on May 26, 2006
British Journal of Anaesthesia 2006 97(2):171-180; doi:10.1093/bja/ael117
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Drug absorption from the small intestine in immediate postoperative patients

J. M. Kennedy1,2,* and A. M. van Rij2

1 School of Pharmacy, University of Otago Dunedin, New Zealand
2 Department of Surgery, University of Otago Dunedin, New Zealand

*Corresponding author: School of Pharmacy, University College Cork, College Road, Cork, Ireland. E-mail: j.kennedy{at}ucc.ie

Background. The effects of surgery on gastric emptying have been documented for a considerable time, but less is known about the effects in the small intestine. It is thought that there is minimal diminution in the absorptive capacity of the small intestine after operation, although there is no literature on drug absorption in the early period after surgery. This study investigated drug absorption from the small bowel in patients undergoing abdominal surgery.

Methods. A prospective study of patients undergoing major abdominal surgery in which patients acted as their own preoperative controls was carried out. Patients were administered the test substances, acetaminophen and 99mTcDTPA, before operation and 2 days after operation. Small intestine transit times, plasma concentrations and other pharmacokinetic variables were compared using Student's paired t-test. Two complementary studies were carried out to establish pharmacokinetic parameters.

Results. There were no significant differences in the pre- and postoperative values of tmax, area under the curve, and area under the moment curve (AUMC) before and after operation (P>0.05). There were significant differences between the pre- and postoperative values of Cmax [Cmax (preop)>Cmax (postop); P<0.05] and the pre- and postoperative values of mean residence time (MRT) [MRT(preop)<MRT(postop); P<0.01].

Conclusions. Drug absorption from the small bowel in the postoperative patient does not differ significantly from its preoperative absorptive capacity.


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