Comparison of two bowel treatments to prevent constipation in post-surgical orthopaedic patients
published online 16 November 2009.
Summary
Introduction
In major orthopaedic surgical procedures the combination of opioid analgesia for pain control and disruptions in mobilisation post-operatively can cause constipation. In order to prevent or relieve constipation in this patient group a post-operative bowel protocol is required. This study compares the use of two treatments to address constipation in this patient group. The results provide information for nursing staff to determine the most effective bowel management protocol for orthopaedic patients.
Aim
To compare the effectiveness of Macrogol 3350 with electrolytes (Movicol®) with a standard bowel treatment in reducing constipation in orthopaedic patients.
Methods
Patients admitted for elective total knee and total hip replacement surgery were randomly allocated to one of two treatment groups. Treatment group 1 received the standard bowel protocol of Coloxyl and Senna®. Patients allocated to treatment group 2 received Macrogol 3350 with electrolytes (Movicol®). Each treatment commenced on Day 1 post-operation. Bowel movements and associated abdominal symptoms such as flatus, pain and nausea were recorded daily.
Results
Patients taking Macrogol 3350 with electrolytes (Movicol®) experienced a bowel movement earlier in the post-operative period (2–4days vs 3–6days; P=0.001). No significant difference in self-reported gastrointestinal symptoms was found between groups.
Conclusions
The findings from this study provide data that may assist in a more effective bowel treatment for post-operative orthopaedic patients.
aOrthopaedic Unit, Calvary Wakefield Hospital, 300 Wakefield Street, Adelaide, SA 5000, Australia
bSchool of Nursing and Midwifery, University of South Australia, City East Campus, North Terrace Adelaide SA 5000, Australia
ABSTRACT