الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Postoperative ileus is a common problem after major abdominal surgery and may lead to significant postoperative morbidity, prolonged hospitalization, and increased health care costs. Several mechanisms are thought to play a role in POI, including sympathetic neural reflexes, local and systemic inflammatory mediators, and changes in various neural and hormonal transmitters. Many potential treatment options exist for POI, but data regarding the efficacy of various therapies are generally limited. It appears that thoracic epidural anesthetic agents decrease the duration of POI, in part by blocking neural reflexes at the spinal cord and by decreasing post-procedure narcotic use by the patient. NSAIDs may also speed recovery of bowel function by inhibiting bowel inflammation and by decreasing opioid use. Prokinetic agents such as metoclopramide and erythromycin have not been conclusively shown to decrease the duration of POI. Early enteral feeding and early ambulation have also not been definitively shown to shorten the duration of POI, but each appears to have other beneficial effects and may decrease postoperative morbidity and thus should be encouraged. Most recently, opioid-receptor antagonists have shown promise in reducing postoperative ileus but still require further studies. Multimodality treatment approaches combining several therapies may represent a logical approach but require further evaluation in larger, randomized trials, as do novel emerging therapies such as vasoactive intestinal peptides and substance P antagonists or nitric oxide synthesis inhibitors. This study was carried out on two hundred women after cesarean section and they divided into two groups: study group one hundred.