New Insights into Anesthesia-induced Postoperative Gastrointestinal Dysfunction: From Bench to Bedside

Area of Science:

• Anesthesiology
• Gastroenterology
• Surgical Care

Background:

• Postoperative Gastrointestinal Dysfunction (PGD) is a common surgical complication linked to anesthesia.
• Enhanced Recovery After Surgery (ERAS) frameworks are driving research into PGD mechanisms and management.
• Optimizing perioperative care is crucial for mitigating PGD.

Purpose of the Study:

• To review the latest advances in anesthesia-induced PGD.
• To focus on PGD mechanisms, anesthetic drug effects, and clinical management.
• To provide evidence-based references for optimizing perioperative care.

Main Methods:

• Comprehensive narrative review of recent PubMed literature.
• Search terms included "anaesthetic drugs," "postoperative gastrointestinal dysfunction," "ERAS," and "multimodal analgesia."
• Inclusion of preclinical and clinical studies.

Main Results:

• Opioids significantly inhibit gastrointestinal motility, contributing to PGD.
• Propofol shows protective effects, while sevoflurane may increase PGD risk.
• Regional anesthesia, multimodal analgesia, and emerging strategies show potential for PGD mitigation.

Conclusions:

• Optimizing anesthetic protocols and reducing opioid reliance are key to PGD prevention.
• Multimodal interventions, personalized anesthesia, and gut-brain axis modulation are important future directions.
• AI-enhanced perioperative care may improve outcomes for PGD.