Postoperative pain relief and gastrointestinal motility

Gastrointestinal motility is normally inhibited for 2-3 days after abdominal surgery. The methods used for postoperative pain relief may themselves also influence gastrointestinal function. Although parenteral and epidural administration of opioids delays gastric emptying and prolongs intestinal transit time, epidural anesthesia with local anesthetics does not influence gastrointestinal motility in volunteers. Clinical studies show that epidural anesthesia does not delay gastric emptying or prolong intestinal transit time as much as parenteral and epidural opioids. Therefore, for postoperative pain relief after abdominal surgery, epidural anesthesia with local anesthetics seems the best alternative to avoid or minimize adverse effects on gastric emptying and intestinal motility.