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Background Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student‐ and trainee‐led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre‐specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non‐selective cyclo‐oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.

O presente artigo resulta de trabalhos de grupo realizados por enfermeiros durante uma formação sobre o processo de supervisão, leccionada pelos autores enquanto membros do Centro de Estágios da Escola Superior de Saúde da Universidade de Aveiro - Portugal. Tem como objectivos aprofundar conhecimentos acerca desta temática, identificar a finalidade das estratégias que são utilizadas e a quais dão mais ênfase. A recolha de dados foi realizada através da narração de episódios significativos, por 20 enfermeiros cooperantes na supervisão, no período de janeiro a fevereiro de 2005. Desenvolveu-se um estudo exploratório-qualitativo tendo-se procedido à análise de conteúdo das referidas narrações. Com o presente estudo verificámos que os enfermeiros, utilizam as estratégias de supervisão com a finalidade de prestar atenção, clarificar, encorajar, servir de espelho, dar opinião, ajudar a encontrar soluções para os problemas, negociar, orientar, estabelecer critérios e condicionar. Da análise dos resultados concluímos que os supervisores deste estudo se aproximam de um perfil não-directivo.