Comparison of Two Postoperative Bowel Regimens in Children With Scoliosis Repair

Area of Science:

• Pediatric Orthopaedics
• Gastroenterology
• Pharmacology

Background:

• Children undergoing orthopaedic surgery are susceptible to postoperative constipation.
• Anesthesia, narcotic use, and reduced mobility contribute to this risk.

Purpose of the Study:

• To compare the efficacy of polyethylene glycol 3350 (PEG) and mineral oil (MO) for managing constipation in pediatric patients post-spinal fusion.
• To analyze medication use and stool outcomes in 36 children.

Main Methods:

• Retrospective chart review of 36 pediatric patients undergoing spinal fusion.
• Comparison of bowel movement frequency, time to first bowel movement, and need for rescue cathartics between PEG and MO groups.
• Assessment of medication refusal rates for both treatments.

Main Results:

• No significant differences were observed between PEG and MO groups regarding bowel movements before discharge (p = .37) or time to first bowel movement.
• Rescue cathartic use (p = .55) and medication refusal rates (p = .37) also showed no statistical difference between groups.
• Medication refusal was high: 90% in the PEG group and 75% in the MO group refused medication at least once.

Conclusions:

• A low percentage (17%) of patients achieved a bowel movement before discharge.
• High rates of medication refusal suggest that the method of preparation may influence compliance.
• The findings indicate a potential need for patient-centered approaches, allowing children to choose their bowel regimen, and warrant further investigation in a larger, prospective study.