Neostigmine Route for Acute Colonic Pseudo Obstruction

Description

Neostigmine is commonly used for medical treatment of acute colonic pseudo obstruction, however, the ideal route of administration has not been determined. Though IV push works rapidly, it is likely associated with the most side effects. This study will compare the efficacy and side effect profile of 2 potential routes of administration: IV push and subcutaneous.

Conditions

Ogilvie Syndrome

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Study Overview

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Study Details

Study overview

Neostigmine is commonly used for medical treatment of acute colonic pseudo obstruction, however, the ideal route of administration has not been determined. Though IV push works rapidly, it is likely associated with the most side effects. This study will compare the efficacy and side effect profile of 2 potential routes of administration: IV push and subcutaneous.

Evaluating the Safety and Efficacy of Different Routes of Neostigmine Administration for Acute Colonic Pseudo Obstruction: a Prospective Randomized Trial

Neostigmine Route for Acute Colonic Pseudo Obstruction

Condition
Ogilvie Syndrome
Intervention / Treatment

-

Contacts and Locations

Los Angeles

Los Angeles University of Southern California Medical Center, Los Angeles, California, United States, 90004

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. Patients with radiologically confirmed acute colonic pseudo obstruction (ACPO).
  • 1. Plain abdominal radiograph or computed tomography imaging
  • 2. Cecal diameter of \>9 cm or transverse colon diameter of \>6 cm
  • 2. Distal obstruction ruled out on imaging (Contrast enema, endoscopy, CT scan)
  • 1. Patients with previous neostigmine administration during current hospitalization
  • 2. Patients with prior attempt at endoscopic decompression on this admission.
  • 3. Patients with base-line heart rate of less than 60 beats per minute or on beta blocker medication
  • 4. Patients with systolic blood pressure of less than 90 mm Hg
  • 5. Signs of bowel perforation, with peritoneal signs on physical examination or free air on radiographs
  • 6. Active bronchospasm requiring medication
  • 7. Treatment with prokinetic drugs such as cisapride or metoclopramide in the 24 hours before evaluation
  • 8. A history of colon cancer or partial colonic resection
  • 9. Signs concerning for colonic obstruction
  • 10. Active gastrointestinal bleeding
  • 11. Pregnancy
  • 12. Serum creatinine concentration of more than 3 mg per deciliter (265μmol per liter).

Ages Eligible for Study

16 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of Southern California,

Meghan Lewis, MD, PRINCIPAL_INVESTIGATOR, University of Southern California

Study Record Dates

2025-08-01