Evaluation of Preoperative Administration of Rectal Indomethacin in Reducing the Severity of Ileus after Open Cholecystectomy

Introduction: Ileus or transient intestinal motility disorder is one of the problems after surgery, which poses challenges facing the medical team. Previous studies approved the preemptive effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ileus; however, the majority of them have focused on animal models. This study aimed to investigate the effects of administration of rectal indomethacin in reducing ileus in patients who underwent cholecystectomy. Materials and Methods: This randomized controlled trial included 40 patients with cholelithiasis who were divided into two groups of indomethacin (n=20) and placebo (n=20). The indomethacin group received 100 mg rectal indomethacin before the operation. Cholecystectomy was performed using an open technique. The recovery of bowel functions (i.e. the time of the first flatus passage, return of appetite, and total dosage of opioid analgesic medications) was evaluated in this study. Results: Time of the first ileus passage (P=0.004), return of appetite time (P=0.06), and reduction of opioid usage (65.62±5.5 mg/day versus 93.26±2.56) were significantly shorter in the indomethacin group, compared to the placebo group. Furthermore, none of the patients had any significant indomethacin-related complications. Conclusion: According to the outcomes of this study, it is concluded that preoperative administration of NSAIDS can be helpful in postoperative ileus reduction.