The postoperative motility dysfunction (POI) is a frequent secondary complication of surgical procedures. The POI results from a number of simultaneous factors of both local and systemic nature. Activation of inhibitory neural reflexes and a mediator response to the surgical proceduře are among the main ones. Neurohumoral response of the organism to painful sti-muli and the effect of the opioid medication ušed during the perioperative period, are the modulating factors. The intraabdo-minal proceduře with manipulation with the intestine results in activation of the mediator response, followed by increased levels of cytokines and other mediators, inhibiting the smooth intestinal musculature contractility. The extent of the traumati-zation of the tissue is a principál factor affecting the extent and duration of the POI.

        Key words: laparotomy - opioids - postoperative ileus - inflammation