Efficiency of serotonin in the prevention of postoperative ileus in patients after robot-assisted radical prostatectomy

Bykova K.M., Lisovoy M.D., Rutkovsky R.V., Shmakova Ya.D., Rodchenko A.M., Izotov G.M., Yechmaeva Ya.V., Yablonskikh D.D., Shepieva G.Z., Shelipanov D.A., Mosoyan M.S., Aleksandrovich Yu.S., Savvina I.A.

1) V.A. Almazov National Medical Research Center, Ministry of Health of the Russian Federation, Saint Petersburg, Russia; 2) Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg, Russia; 3) I.I. Mechnikov North-Western State Medical University, Ministry of Health of the Russian Federation, Saint Petersburg, Russia

Introduction. Postoperative ileus is a transient impairment of gastrointestinal motility that occurs after surgery and anesthesia. Currently, there is a sustained trend toward investigating the role of serotonin as a regulator of intestinal motor function. Aim. To evaluate the clinical efficiency of serotonin (Dinaton) in the prevention of postoperative ileus, pain severity, and hemostasis parameters in patients after robot-assisted radical prostatectomy (RARP). Materials and methods. A single-center prospective randomized controlled clinical study was conducted and included 70 patients after RARP. In the postoperative period, patients were divided into two groups: the main group and the control group. Patients in the main group received Dinaton in accordance with the official prescribing information. Assessment time points were 10, 24, 48, and 72 hours after surgery. Clinically, patients were evaluated using the VAS (visual analogue scale) and VAS–BLOAT scales. Laboratory assessment included serial measurements of C-reactive protein (CRP) and serum hemoglobin. Drain output volume and the occurrence of defecation were also recorded. Results. In the group receiving Dinaton, a significant decrease in CRP was observed at 48 hours (р=0,00011). No significant differences were found between the main and control groups in hemoglobin levels or drain output volume (p>0,05). According to the VAS, significantly lower postoperative pain intensity persisted throughout the 72-hour period in the main group, along with a reduced need for analgesics compared with the control group. Abdominal bloating was less pronounced in the Dinaton group (VAS–BLOAT) over three days (p<0,05). Conclusion. Use of serotonin in urological patients after RARP significantly reduced pain intensity and abdominal bloating and decreased CRP levels, indicating a more rapid normalization of the systemic inflammatory response.

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About the Authors

Corresponding author: K.M. Bykova – anesthesiologist, V.A. Almazov National Medical Research Center, Ministry of Health of the Russian Federation; Assistant, Department of Anesthesiology, Resuscitation and Emergency Pediatrics, Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg, Russia; e-mail: dr.kristinamikhailovna@gmail.com

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