The Effects of Combined Gum-chewing and Parenteral Metoclopramide on the Duration of Postoperative Ileus After Abdominal Surgery.

Autor:	Ulasi IB; Department of Surgery, University College Hospital, Ibadan, Nigeria., Afuwape OO; Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria., Ayandipo OO; Division of Oncological Surgery, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria., Fakoya A; Division of Endocrine Surgery, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria., Irabor DO; Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.
Jazyk:	angličtina
Zdroj:	Journal of the West African College of Surgeons [J West Afr Coll Surg] 2023 Oct-Dec; Vol. 13 (4), pp. 46-57. Date of Electronic Publication: 2023 Sep 16.
DOI:	10.4103/jwas.jwas_38_23
Abstrakt:	Background: Postoperative ileus remains the most common cause of prolonged hospital stay after abdominal surgery. Various agents have been tested in the treatment of postoperative ileus but no agent alone has achieved effectiveness as postoperative ileus is of multifactorial aetiology. Objectives: The aim of this study was to assess the effects of combined use of gum-chewing and parenteral metoclopramide on the duration of postoperative ileus after abdominal surgery. Materials and Methods: This was a randomised controlled study of patients aged 16-65 years who underwent elective abdominal surgeries. Patients were randomised into a gum-metoclopramide (GM) group, a gum-only (G) group, a metoclopramide-only (M) group and a control (C) group. Patients in the GM group chewed gum and received intravenous metoclopramide, each 8 hourly. In G group, patients chewed only gum, whereas those in M group received only 10mg of intravenous metoclopramide, 8 hourly. To C group, 10 mL of intravenous sterile water was given 8 hourly. Patients were monitored for time to passage of first flatus or faeces. Groups were compared for the duration of postoperative ileus and duration of hospital stay using analysis of variance. Statistical significance was set at a P value of <0.05. Results: Fifty-two out of the 105 recruited patients were eligible for analysis. The male-to-female ratio was 1:1.9 with a median age of 57.0 years (interquartile range [IQR] =16 years). Prolonged postoperative ileus occurred in 9.4% ( n = 5) of the patients (GM = 2, G = 1, M = 2, C = 0; P = 0.604) and was associated with longer duration of nasogastric tube use ( P = 0.028). The duration of postoperative ileus was 3 days (IQR = 2), 2.5 days (IQR = 3.3), 4 days (IQR = 1.5) and 3 days (IQR = 2) in the GM, G, M, and C groups, respectively ( P = 0.317), whereas the median duration of hospital stay was 7 days (IQR = 3), shortest in G group (6.5 days, IQR = 8) and longest in M group (9 days, IQR = 3) ( P = 0.143). Conclusions: The combined use of gum-chewing and parenteral metoclopramide had no effect on the duration of postoperative ileus following abdominal surgeries in adult surgical patients. Competing Interests: The authors do not have any personal interest/gain that may affect the unbiased conduct, results and presentation of this study to declare. (Copyright: © 2023 Journal of the west African college of surgeons.)
Databáze:	MEDLINE
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