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Published on: August 1, 2019
Effectiveness of a Preoperative Bowel Preparation Protocol for Patients With Adolescent Idiopathic Scoliosis to
Alzakri Abdulmajeed1,2,3
1Department of Orthopaedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
A preoperative bowel preparation with bisacodyl significantly reduced gastrointestinal issues and hospital stays for adolescent idiopathic scoliosis patients undergoing surgery. This protocol enhances recovery and patient outcomes.
Area of Science:
- Orthopedic Surgery
- Gastroenterology
- Clinical Trial Research
Background:
- Adolescent idiopathic scoliosis surgery often leads to gastrointestinal issues like constipation and prolonged hospital stays.
- Opioid use post-surgery is a significant contributor to these gastrointestinal complications.
Purpose of the Study:
- To evaluate the effectiveness of a preoperative bowel preparation protocol using bisacodyl.
- To reduce postoperative gastrointestinal morbidities and hospital length of stay in adolescent idiopathic scoliosis patients.
Main Methods:
- A randomized controlled trial involving 87 patients with adolescent idiopathic scoliosis.
- Group A received bisacodyl preoperatively; Group B received no preoperative medication.
- Demographic data, comorbidities, and opioid consumption were assessed.
Main Results:
- Patients receiving bisacodyl (Group A) reported fewer postoperative gastrointestinal symptoms compared to Group B.
- The average hospital stay was significantly shorter for Group A (4.1 days) than Group B (5.3 days) (P = .01).
Conclusions:
- Preoperative bowel preparation with bisacodyl is effective in mitigating postoperative gastrointestinal complications.
- This protocol can shorten hospital length of stay for patients undergoing adolescent idiopathic scoliosis surgery.
Abstract:
Study DesignRandomised controlled trial.ObjectiveThis study aimed to determine the effectiveness of a preoperative bowel preparation protocol comprising bisacodyl to minimize postoperative gastrointestinal morbidities and the hospital length of stay for patients with adolescent idiopathic scoliosis.Summary of Background DataPatients who undergo scoliosis correction surgery frequently experience postoperative gastrointestinal morbidities and a prolonged hospital length of stay. Emesis, paralytic ileus and constipation are the most common gastrointestinal morbidities. Opioid medication is a well-known risk factor for gastrointestinal complications after scoliosis correction surgery.MethodsEighty-seven patients (22 boys [25.3%] and 65 girls [74.7%]) with a mean age of 17.7 years (standard deviation [SD], ±2.2 years) diagnosed with adolescent idiopathic scoliosis were enrolled in this study and randomized into 2 groups. Group A comprised 44 patients who received a preoperative bowel preparation comprising bisacodyl. Group B comprised 43 patients who did not receive any preoperative medication. Demographic data, height, weight, medical and surgical comorbidities, Risser status, number of instrumented levels and preoperative opioid consumption of all patients were evaluated.ResultsGroup A experienced fewer postoperative abdominal symptoms than group B. The mean hospital length of stay was 4.1 days (SD, ±.6 days; median, 4 days; range, 3-5 days) for group A; however, it was 5.3 days (SD, ±.8 days; median, 5 days; range, 4-7 days) for group B (P = .01).ConclusionThe use of a bowel preparation protocol before scoliosis correction surgery for patients with adolescent idiopathic scoliosis can effectively decrease postoperative gastrointestinal morbidities and the hospital length of stay.
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