Comparison of two bowel treatments to prevent constipation in post-surgical orthopaedic patients

Abstract

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.