Authors: (including presenting author): :
Siu SK(1), Joeng HKM(1), Wong KY(1), Cheung DST(2)
Affiliation: :
(1)Department of Surgery, United Chrisitan Hospital (2)School of Nursing, Li Ka Shing Faculty of Medicine,The University of Hong Kong
Keyword 1: :
Postoperative ileus
Introduction: :
Patients undergoing colorectal surgery are prone to postoperative ileus. Although considerable evidence supports the benefits of early out-of-bed mobilization as recommended in the Enhanced Recovery After Surgery (ERAS) program, low adherence rates have been observed. Little is known about the effectiveness of simple bed exercises for reducing postoperative ileus in patients undergoing colorectal surgery.
Objectives: :
This study aims to examine the effectiveness of simple bed exercises for reducing postoperative ileus in patients undergoing colorectal surgery.
Methodology: :
Elective colorectal surgery patients aged 18 years or older were recruited and randomized into an intervention group (simple in-bed exercises) and a control group. Patients in the intervention group were educated about simple in-bed exercises by nurses, with the assistance of instructional videos, on the day prior to surgery. The intervention group was advised to perform these exercises starting on postoperative day 1 for 15 minutes at three time points—breakfast, lunch, and dinner—until their first postoperative defecation. The control group received usual care. Primary outcome was time to first defecation. The secondary outcomes included time to first flatus and tolerance of oral intake. Logbooks were given to patients of both groups for recording the outcomes. The analysis was based on the intention-to-treat principle.
Result & Outcome: :
Seventy six patients were randomized (38 intervention group and 38 control group). There were no dropouts. The exercise compliance rate in the intervention group was satisfactory (79%). Compared to the control group, the intervention group reported significantly shorter time to first defecation (mean difference=21.0 hours; p=0.008), first flatus (mean difference=12.3 hours; p=0.017), and time to tolerate of oral diet (mean difference=32.2 hours; p=0.046). No adverse event as a result of the intervention was reported.
