Does postoperative misoprostol use induce intestinal motility? A prospective randomised double-blind trial

Area of Science:

• Gastroenterology
• Surgical Recovery
• Pharmacology

Background:

• Misoprostol is known to increase colonic activity.
• Previous studies indicate it decreases colonic transit time in chronic constipation.

Purpose of the Study:

• To evaluate the effectiveness of rectally administered misoprostol in promoting intestinal motility post-gynecological surgery.
• This study aimed to assess if misoprostol aids in early postoperative recovery.

Main Methods:

• A prospective, randomized, double-blind study involving 80 women undergoing hysterectomy.
• Participants received either 200 mcg (Group A) or 400 mcg (Group B) of rectal misoprostol, or a placebo (Group C).
• Intestinal motility was monitored by hourly auscultation of bowel sounds, and side effects, flatus passage time, and analgesic requirements were recorded.

Main Results:

• No significant difference in the time to presence of bowel sounds in all four quadrants was observed across the groups.
• Flatus passage time showed no variation between the misoprostol and placebo groups.
• Nausea incidence was significantly higher in the 400 mcg misoprostol group (Group B), and both misoprostol groups required more analgesics compared to controls.

Conclusions:

• Rectal misoprostol administration does not accelerate intestinal motility in the early postoperative phase following gynecological surgery.
• The use of misoprostol in this context did not facilitate earlier oral food intake.
• Adverse effects, including distension and vomiting, were noted, necessitating additional analgesics and potentially limiting oral diet.