Bowel management post major joint arthroplasty: A randomised controlled trial to test two pre-admission bowel regimens

Abstract

BackgroundThe length of stay for patients undergoing joint arthroplasty has reduced but there is a paucity of knowledge relating to bowel management within this enhanced recovery framework. AimThe study's primary aim was to determine which of two dosage regimens of macrogol (Movicol®) commenced pre-operatively is most effective in facilitating a return to normal bowel function. ProcedureNinety-one eligible patients were randomised to one of three groups: 1) commence macrogol one sachet in the morning for two days prior to surgery; 2) commence macrogol one sachet, morning and evening of the day prior to surgery; or 3) control group. ResultsSeventy-seven percent of patients in group one, and 83% of group two had returned to normal bowel function by one-week post discharge compared to 70% of control patients (p = .470). Participants in group one required less aperients in the week following discharge compared with the other two groups although the result was not statistically significant (p = .060). ConclusionDespite not reaching statistical significance, the results are considered clinically significant. The authors recommend patients commence macrogol one sachet in the morning for the two days prior to admission for major joint arthroplasty and the Murdoch Bowel Protocol® continue to be followed for inpatients.