What are the factors that impact gastrointestinal (GI) recovery following surgery? How does GI recovery impact length of hospital stay?

Describe the evidence relevant to multimodal pain management, fluid management, surgical technique, and early/sham feeding in the management of patients with postoperative ileus.
 

Describe the use of pharmacologic agents in the management of postoperative ileus, including laxatives, prokinetic agents, and opioid receptor antagonists.

Describe the importance of interdisciplinary collaboration in implementing a multimodal approach to postoperative ileus and GI recovery following surgery.
 

What steps would you recommend for a clinician who would like to implement a new evidence-based multimodal program for enhanced surgical recovery at their institution?

Discuss surgical quality improvement measures that pertain to gastrointestinal recovery following surgery, or opportunities to incorporate GI recovery into existing surgical quality improvement initiatives.
 

What are the barriers to a multimodal approach to the management of patients with POI, and what are the ways to improve implementation?

What are some of the formulary issues related to patients undergoing bowel resection and at risk for POI? What is the role of the pharmacist in the management of POI?
 

While it is not possible to predict who will be most affected by POI, is there any advantage to conducting "risk profiling" of patients to improve the level of care?

Discuss the rehospitalization rate of patients with POI. What are the most common reasons for return to the hospital? Are there any predisposing factors? Does the multimodal approach reduce the likelihood of rehospitalizations?
 

Discuss the use of peripherally acting µ-opioid receptor antagonists for POI, including advantages and disadvantages. Describe the emerging treatments for POI.

Do you think that there is a benefit to the use of peripherally acting µ-opioid receptor antagonists in patients undergoing bowel resection via laparoscopic surgery and/or with post-operative epidural pain control?