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Bowel management post major joint arthroplasty: results from a randomised controlled trial
Gail M Ross-Adjie1, Leanne Monterosso2, Max Bulsara3
1Centre for Nursing and Midwifery Research, St John of God Murdoch Hospital, 100 Murdoch Drive, Murdoch 6150, Australia; The University of Notre Dame Australia, Fremantle, Australia.
Aim:
To evaluate the effect of a new post-operative bowel protocol in total hip and total knee replacement patients.
Background:
Up to 65% of total hip and total knee replacement patients experience some degree of constipation post-operatively. A lack of robust evidence to guide bowel management and reduce constipation in this cohort was the impetus for this study.
Design:
A multisite cluster randomised trial in private secondary and tertiary hospitals.
Methods:
In total 331 patients were recruited across seven Australian hospitals over 13 months. Control participants (n = 171) received routine bowel management whilst intervention participants (n = 160) received bowel management as per the trial protocol.
Results:
Intervention patients took 6 days less than controls to return to normal bowel function, and were more than seven times more likely to return to normal bowel function by day 5 post operatively. Age, gender and length of pre-operative fasting had no effect on these outcomes.
Conclusion:
These results support the use of the Murdoch Bowel Protocol(®) for hip and knee replacement patients and may be relevant for other patient groups who experience opioid induced bowel dysfunction.
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