[Risk factors of nasogastric tube placement after elective colorectal surgery included in a rehabilitation programme: a multivariate analysis]
| Autor: | C, Aveline, A, Le Roux, H, Le Hetet, P, Vautier, F, Cognet, F, Bonnet |
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| Jazyk: | francouzština |
| Rok vydání: | 2012 |
| Předmět: |
Male
Postoperative Care Colon Nutritional Support Rectum Kaplan-Meier Estimate Middle Aged Survival Analysis Body Mass Index Body Temperature Logistic Models Elective Surgical Procedures Risk Factors Monitoring Intraoperative Antiemetics Humans Droperidol Female Colorectal Surgery Intubation Gastrointestinal Early Ambulation Aged |
| Zdroj: | Annales francaises d'anesthesie et de reanimation. 32(1) |
| ISSN: | 1769-6623 |
| Popis: | Nasogastric tube placement (NTP) is no more systematically recommended in patients scheduled for elective colorectal surgery but could be necessary in case of postoperative vomiting. The aim of this study was to determine independent risk factors for NTP after colorectal surgery.We performed an observational study including 290 patients scheduled for elective colorectal surgery included in an enhanced recovery programme: immunonutrition, thoracic epidural analgesia, antiemetic prophylaxis, respiratory physiotherapy, absence of NT and drainage, forced mobilization and oral nutrition. The main outcome was the occurrence of vomiting requiring NTP. Univariate analysis included: age, sex, BMI, American Society of Anesthesiologist Physical Status Classification System (ASA), duration of surgery, epidural analgesia, and mobilization, intraoperative fluid, temperature, laparotomy, use of droperidol, parenteral nutrition, stoma, diabetes, hypertension or coronary disease, COPD, type of surgery. A logistic regression was performed to determine independent risk factors of NTP.Among the 290 patients included, 277 were analyzed. The incidence of NTP was 10.5% (95%CI [7.4-14.6%]). Univariate analysis documented BMI, low temperature in PACU (35°C), ASA scores, duration of surgery and epidural analgesia, rectal and sigmoid resections, diabetes, transfusion, no use of droperidol, duration of mobilization, conversion to laparotomy. Three independent risk factors were associated with NTP: temperature in SSPI35.5°C (OR: 14.49; IC95% [4.52-45.45], P0.0001), BMI21kg/m(2) (8.40; [1.99-35.71], P=0.0038) and lack of postoperative droperidol administration (3.37 [1.02-11.39], P=0.04).After colorectal surgery tolerance to rapid oral feeding is impaired by denutrition and postoperative hypothermia. The combined used of postoperative droperidol should also be considered to avoid postoperative NTP. |
| Databáze: | OpenAIRE |
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