Recovery Of Gastrointestinal Function In Patients Research Articles

Impact of intravenous dexmedetomidine on postoperative gastrointestinal function recovery: an updated meta-analysis.

Postoperative ileus (POI) is a complication that may occur after abdominal or nonabdominal surgery. Intravenous dexmedetomidine (Dex) has been reported to accelerate postoperative gastrointestinal function recovery; however, updated evidence is required to confirm its robustness. To identify randomized controlled trials examining the effects of perioperative intravenous Dex on gastrointestinal function recovery in patients undergoing noncardiac surgery, databases including MEDLINE, EMBASE, Google Scholar, and Cochrane Library were searched on August 2023. The primary outcome was time to first flatus. Secondary outcomes included time to oral intake and defecation as well as postoperative pain scores, postoperative nausea/vomiting (PONV), risk of hemodynamic instability, and length of hospital stay (LOS). To confirm its robustness, subgroup analyses and trial sequential analysis were performed. The meta-analysis of 22 randomized controlled trials with 2566 patients showed that Dex significantly reduced the time to flatus [mean difference (MD):-7.19h, P <0.00001), time to oral intake (MD: -6.44h, P =0.001), time to defecation (MD:-13.84h, P =0.008), LOS (MD:-1.08 days, P <0.0001), and PONV risk (risk ratio: 0.61, P <0.00001) without differences in hemodynamic stability and pain severity compared with the control group. Trial sequential analysis supported sufficient evidence favoring Dex for accelerating bowel function. Subgroup analyses confirmed the positive impact of Dex on the time to flatus across different surgical categories and sexes. However, this benefit has not been observed in studies conducted in regions outside China. Perioperative intravenous Dex may enhance postoperative gastrointestinal function recovery and reduce LOS, thereby validating its use in patients for whom postoperative ileus is a significant concern.

Clinical observation of gastrointestinal function recovery in patients after hepatobiliary surgery.

The liver is an important metabolic and digestive organ in the human body, capable of producing bile, clotting factors, and vitamins. To investigate the recovery of gastrointestinal function in patients after hepatobiliary surgery and identify effective rehabilitation measures. A total of 200 patients who underwent hepatobiliary surgery in our hospital in 2022 were selected as the study subjects. They were divided into a control group and a study group based on the extent of the surgery, with 100 patients in each group. The control group received routine treatment, while the study group received targeted interventions, including early enteral nutrition support, drinking water before gas discharge, and large bowel enema, to promote postoperative gastrointestinal function recovery. The recovery of gastrointestinal function was compared between the two groups. Compared with the control group, patients in the study group had better recovery of bowel sounds and less accumulation of fluids in the liver bed and gallbladder fossa (P < 0.05). They also had shorter time to gas discharge and first meal (P < 0.05), higher overall effective rate of gastrointestinal function recovery (P < 0.05), and lower incidence of postoperative complications (P < 0.05). Targeted nursing interventions (early nutritional support, drinking water before gas discharge, and enema) can effectively promote gastrointestinal function recovery in patients undergoing hepatobiliary surgery and reduce the incidence of complications, which is worthy of promotion.

Retracted: Value of Humanized Nursing under Emergency Green Channel on Gastrointestinal Function Recovery in Patients with Acute Intestinal Obstruction after Operation.

[This retracts the article DOI: 10.1155/2023/2303766.].

Value of Humanized Nursing under Emergency Green Channel on Gastrointestinal Function Recovery in Patients with Acute Intestinal Obstruction after Operation.

Acute intestinal obstruction (AIO) is one of the most common surgical acute abdomens. Emergency green channel refers to a fast and efficient service system provided by hospitals for critically ill patients. It is the key to ensure that emergency patients receive timely, standardized, efficient and thoughtful medical services, improve the success rate of rescue, and reduce medical risks. Acute intestinal obstruction is mainly treated by surgery in the clinic. Previous reports have shown that the application of different nursing methods in the operation of acute intestinal obstruction has different effects on the results of surgical treatment. In this study, the clinical data of 80 patients with AIO were retrospectively analyzed to explore the value of humanistic care under the emergency green channel in promoting the recovery of gastrointestinal function after AIO surgery.

Evaluation of early liquid drinking after radical gastrectomy in gastric cancer: a Chinese multicenter propensity score matching analysis.

Enhanced recovery after surgery is used in gastrointestinal surgery. This study aimed to access the effects of early liquid drinking (ELD) on gastrointestinal function recovery in patients with gastric cancer (GC) who underwent radical gastrectomy, as high-quality evidence on the outcomes of ELD after gastrectomy is currently lacking. Clinicopathological data of patients with GC from 11 centers were retrospectively analysed. Clinical outcomes were investigated in 555 patients, including 225 who started drinking liquid within 48 h (ELD group) of surgery and 330 who started drinking liquid after flatus resumption (traditional liquid drinking [TLD] group). Propensity score matching (PSM) analysis was performed using a match ratio of 1:1 and 201 patients were selected from each group for the analysis. Primary outcome was time to first passage of flatus. Secondary outcomes included time to first defecation, post-operative hospitalization days, occurrence of short-term post-operative complications, and hospitalization costs. After PSM, baseline characteristics were not significantly different between the two groups. The time to first flatus (2.72 ± 1.08 vs 3.36 ± 1.39 days), first defecation (4.34 ± 1.85 vs 4.77 ± 1.61 days), and post-operative hospital stay (8.27 ± 4.02 vs 12.94 ± 4.43 days) were shorter in the ELD group than in the TLD group (all P < 0.05). The ELD group had lower hospitalization costs than the TLD group ([7.83 ± 2.44 vs 8.78 ± 3.41] × 104 RMB, P = 0.041). No significant differences were observed in the incidence of post-operative complications. Compared with TLD, post-operative ELD could promote rapid recovery of gastrointestinal function and reduce hospitalization costs; moreover, ELD does not increase the risk of post-operative complications.

Impact of intravenous dexmedetomidine on gastrointestinal function recovery after laparoscopic hysteromyomectomy: a randomized clinical trial

Postoperative intestinal ileus is common after laparoscopic surgery, the incidence of those after hysterectomy was 9.2%. Anesthesia is one of the independent risk factors of postoperative ileus. Dexmedetomidine has been widely used in perioperative anesthesia and previous reports suggested that intraoperative dexmedetomidine may be associated with the improvement of gastrointestinal function recovery after abdominal surgery. We hypothesized that dexmedetomidine could improve gastrointestinal function recovery after laparoscopic hysteromyomectomy. Participants in elective laparoscopic hysteromyomectomy were enrolled with a single dose of 0.5 μg kg−1 dexmedetomidine or the same volume of placebo intravenously administered for 15 min, followed by continuous pumping of 0.2 μg kg−1 h−1 of corresponding drugs until 30 min before the end of surgery. The primary outcome was the time to first flatus. Secondary outcomes were the time to first oral feeding and the first defecation, the occurrence of flatulence, pain score and postoperative nausea and vomiting until 48 h after the surgery. Eventually, 106 participants (54 in dexmedetomidine group and 52 in placebo group) were included for final analysis. The time to first flatus (SD, 25.83 [4.18] vs 27.67 [3.77], P = 0.019), oral feeding time (SD, 27.29 [4.40] vs 28.92 [3.82], P = 0.044), the time to first defecation (SD, 59.82 [10.49] vs 63.89 [7.71], P = 0.025), abdominal distension (n%, 12 (22.2) vs 21 (40.4), P = 0.044), PONV at 24 h (n%, 10 (18.5) vs 19 (36.5), P = 0.037), NRS 6 h (3.15(0.68) vs 3.46 (0.87), P = 0.043) and NRS 12 h (3.43 (0.88) vs 3.85 (0.85), P = 0.014) of dexmedetomidine group were significantly shorter than those of the placebo group. Intraoperative dexmedetomidine reduced the time to first flatus, first oral feeding, and first defecation. These results suggested that this treatment may be a feasible strategy for improving postoperative gastrointestinal function recovery in patients undergoing laparoscopic hysteromyomectomy.

Ultrasound-guided stellate ganglion block accelerates postoperative gastrointestinal function recovery following laparoscopic radical gastrectomy for gastric cancer

To explore the effects of ultrasound-guided stellate ganglion block (SGB) on perioperative stress response, gastrointestinal hormones and postoperative gastrointestinal function recovery in patients undergoing laparoscopic radical gastrectomy for gastric cancer. This study was conducted among 60 American Society of Anesthesiologists (ASA) class II-III patients with gastric cancer (regardless of gender, aged 35-75 years with BMI of 18.5-26 kg/m2) undergoing elective laparoscopic radical gastrectomy. The patients were randomized into experimental group (S group, n=30) and control group (NS group, n=30). In S group, SGB at the C6 level of the right cervical spine was performed under ultrasound guidance 15 min before induction of anesthesia by injection of 7 mL 0.5% ropivacaine; the patients in NS group received injections of normal saline in the same manner. Peripheral venous blood samples were collected before SGB (T1), after surgery (T2), and on the 2nd and 6th days after surgery (T3 and T4) for determination of the levels of motitin (MOT), vasoactive intestinal peptide (VIP), cortisol (COR), and blood glucose (GLU). Intraoperative usage of sufentanil, recovery rate of intestinal sounds at 36, 48, 60, 72, 84 and 96 h after operation and the time of first passage of flatus were recorded and compared between the two groups. There was no significant difference in the total amount of sufentanil consumption between the two groups. Compared with those in NS group, the patients in S group had significant lower COR and VIP levels (P < 0.05) and higher MOT level (P < 0.05) at T2, T3 and T4. Glu level at T2 and T3 was also significantly lower in S group (P < 0.05). The recovery rates of intestinal sounds at 36, 48, 60, 72 and 84 h after surgery were significantly higher (P < 0.05) and the time of the first passage of flatus was earlier in S group than in NS group (P < 0.05). In patients with gastric cancer undergoing laparoscopic radical gastrectomy, ultrasound-guided SGB can reduce postoperative stress level, promote the recovery of gastrointestinal hormone secretion, and accelerate postoperative recovery of gastrointestinal functions.

Auricular therapy improves gastrointestinal function in patients with gynecological laparoscopic surgery: A protocol for systematic review and meta analysis.

Background:Gynecological laparoscopic surgery is the main method to treat gynecological diseases, but postoperative gastrointestinal reactions are more common in patients. Auricular therapy, as a characteristic therapy of Traditional Chinese Medicine, can improve gastrointestinal symptoms such as nausea and vomiting by stimulating the conduction of acupoints through the nervous system on internal organs, but there are studies questioning the efficacy of auricular therapy. Therefore, the purpose of this study is to prove the efficacy and safety of auricular therapy in promoting gastrointestinal function recovery after gynecological laparoscopic surgery, and to provide reference value for future clinical practice.Methods:To search English databases (PubMed, Excerpta Medical Database [Embase], Web of Science, the Cochrane Library) and Chinese databases (Chinese National Knowledge Internet [CNKI], WanFang, Viper, Chinese Biomedical Literature Database) by computer, and conduct a randomized controlled trial on the effect of aural point therapy on gastrointestinal function recovery of patients after gynecological laparoscopic surgery from the establishment of the database to October 2020. Two researchers independently evaluate the quality of the included studies and extract the data, and meta-analysis of the included literature is carried out using RevMan5.3 software.Results:In this study, the efficacy and safety of auricular therapy in the recovery of gastrointestinal function after gynecological laparoscopic surgery are evaluated from the aspects of first anal exhaust time, bowel sound recovery time, and incidence of gastrointestinal complications.Conclusion:This study will provide reliable evidence-based evidence for auricular therapy in the treatment of gastrointestinal function after gynecologic laparoscopic surgery.Ethics and dissemination:Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number:DOI 10.17605 / OSF.IO / ZSPGA

Transcutaneous electrical acupuncture stimulation (TEAS) for gastrointestinal dysfunction in adults undergoing abdominal surgery: study protocol for a prospective randomized controlled trial

BackgroundPostoperative gastrointestinal (GI) dysfunction (PGD) is a common problem after abdominal surgery. PGD can increase the length of hospital stay and may lead to serious complications. Acupuncture and moxibustion are alternative therapies for PGD that have been used in some settings. However, the effect of preventive application of acupuncture or transcutaneous electrical acupuncture stimulation (TEAS) is still uncertain. The purpose of this study is to investigate the efficacy of the continuous application of TEAS on GI function recovery in adults undergoing abdominal surgery. At the same time, we will try to confirm the mechanism of TEAS through the brain–gut axis.Methods/designThis study is a prospective, single-center, two-arm, randomized controlled trial that will be performed in a general hospital. In total, 280 patients undergoing abdominal surgery were stratified by type of surgery (i.e. gastric or colorectal procedure) and randomized into two treatment groups. The experimental group will receive TEAS stimulation at L14 and PC6, ST36 and ST37. The sham group will receive pseudo-TEAS at sham acupoints. The primary outcome will be the time to the first bowel motion by auscultation. The recovery time of flatus, defecation, the changes in perioperative brain–intestinal peptides, postoperative pain, perioperative complications, and hospitalization duration will be the secondary outcomes.DiscussionThe results of this study will demonstrate that continuous preventive application of TEAS can improve the GI function recovery in patients undergoing abdominal surgery and that this effect may act through brain–gut peptides.Trial registrationChinese Clinical Trial Registry, ChiCTR1900023263. Registered on 11 May 2019.

Study on the timing of intervention of gastrointestinal function recovery in patients after laparoscopic cholecystectomy with acupoint application of traditional Chinese medicine

Study on the timing of intervention of gastrointestinal function recovery in patients after laparoscopic cholecystectomy with acupoint application of traditional Chinese medicine

A meta-analysis of the effectiveness and safety of acupuncture intervention in gastrointestinal function after gynecilogical and obstetrical operations

Objective To systematically evaluate the effectiveness and safety of acupuncture intervention in gastrointestinal function after gynecilogical and obstetrical operations. Methods Databases of SinoMed (1997-2017), VIP (1997-2017), Wanfang (1997-2017), CNKI (2007-2017), PubMed (1997-2017) and Cochrane Library (2017 fourth) were searched by computers (supplemented by manual searching). The randomized controlled trials were included on the gastrointestinal function recovery after acupuncture intervention in gynecilogical and obstetrical operations. The data were extracted independently and cross-checked by two evaluators. Then the quality was evaluated according to the Cochrane system assessor manual 4.2.8, and RevMan 5.3 software was used for meta-analysis. Results A total of 1 192 patients were included in 14 randomized controlled trials. Meta-analysis showed that the effective rate [OR=6.09, 95% CI (2.91, 12.75), P<0.01], the time to first passage of feces [MD=-14.72, 95% CI(-16.00, -13.44), P<0.01], the time to first bowel motion [MD=-8.81, 95% CI (-10.34, -7.28), P<0.01] and the time to first flatus [MD=-11.84, 95% CI (-15.31, -8.36), P<0.01] in the acupuncture group were higher than those in control group. Conclusions Acupuncture intervention in gynecilogical and obstetrical operations was safe and effective for gastrointestinal function recovery of patients. However, the above conclusions are required to have further validation with more highly qualified randomized controlled trials for the limited number of literature and the low quality of some studies. Key words: Acupuncture; Postoperative period; Gynecologic surgical procedures; Obstetric surgical procedures; Gastrointestinal function; Systematic review; Meta-analysis

Effect of postoperative precision nutrition therapy on postoperative recovery for advanced gastric cancer after neoadjuvant chemotherapy

Objective: To investigate the effect of postoperative precision nutrition therapy on postoperative recovery (PR) of patients with advanced gastric cancer (AGC) after neoadjuvant chemotherapy (NC). Methods: 71 subjects were randomly divided into 2 groups. The 34 patients of research group were treated with postoperative precision nutrition treatment according to the indirect energy measurement method. The 31 patients of control group were treated with traditional postoperative nutrition treatment. All participants were measured for body mass index (BMI), NRS2002, PG-SGA and relevant laboratory test within the 1st day before surgery and 7th day after surgery. Moreover, the difference between two groups in short-term effects were evaluated. Results: The daily energy supply of control group was 30.1%-43.74% higher than that of the experimental group (P<0.05). The resting energy expenditure (REE) of the research group after surgery was lower than that before operation. The levels of prealbumin, albumin and lymphocyte count were higher in research group than the controls at the 7th day after surgery whereas the opposite was true for the creatinine, urea nitrogen, C-reactive protein and procalcitonin (P<0.05). Similarly, the rate of malnutrition and nutritional risk became lower in the research group (P<0.05). The gastrointestinal function recovery of patients in the research group was comparable to that of the control group (P>0.05). Moreover, the complication rate and hospitalization costs of in research group were significantly lower than that of in control group (P<0.05). For patients with or without nutritional risks before surgery, the nutritional index and inflammatory index in the research group were better than those in the control group. Conclusion: Postoperative precision nutrition therapy may improve the postoperative nutritional status and short-term effects of patients with AGC after NC.

Effect of continuous quality improvement program on gastrointestinal function recovery in patients after laparoscopic surgery for appendicitis

Effect of continuous quality improvement program on gastrointestinal function recovery in patients after laparoscopic surgery for appendicitis

Effect of comprehensive nursing intervention on gastrointestinal function recovery in patients after cardiac surgery

Effect of comprehensive nursing intervention on gastrointestinal function recovery in patients after cardiac surgery

Clinical research on nursing of early gastrointestinal function recovery of patients with severe acute pancreatitis

目的 探讨重症急性胰腺炎早期胃肠道功能复苏的方法.方法 对我院2003年6月-2007年6月确诊的重症急性胰腺炎35例采用了中西医结合为主的三步法序贯复苏胃肠功能;与2000年1月-2003年6月的31例的常规综合治疗方法对比分析.结果 三步法序贯复苏胃肠功能的方法,肠道功能恢复、启动肠内营养的时间先于对照组.结论 三步法用于重症急性胰腺炎病人的早期胃肠功能复苏,安全、有效。