Gum chewing and bowel function after Caesarean section under spinal anesthesia

Akalpler, Ozlem; Okumuş, Hülya

doi:10.12669/pjms.345.15772

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…Our study showed that early mobilization after C-section conducted by a multidisciplinary health care team could singly shorten the time until the patient’s first ambulation, shorten the length of hospital stay and reduce complications after C-section. This result is consistent with those of many previous studies [ 18 , 19 ], and early mobilization after C-section can improve patient recovery. In the study, all of the clinical practices included in the intervention were successfully implemented except abdominal drainage tube removal within 24 h and activity recording by patients, and the onset time of off-bed activities decreased from 31.89 ± 9.50 h to 20.01 ± 4.65 h.…”

Section: Discussionsupporting

confidence: 93%

“…Preoperative education and preoperative behavioural interventions have a direct impact on patients’ postoperative rehabilitation and were well documented in this study. According to previous study results, postoperative patients may suffer postoperative problems such as incision pain [ 19 ], intestinal distension [ 18 ], and incision site or urinary tract infections [ 19 , 20 ], and they would refuse mobilization. Therefore, preoperative education of patients is an important part of postoperative care in C-sections [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study

et al. 2022

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Background Patients should be encouraged to mobilize with 24 h of caesarean section. However, the time of the first off-bed activity after surgery is usually 24 ~ 48 h in China. Due to the lack of knowledge of early off-bed activities, lack of attention to medical pain, and the absence of systematic evidence for the clinical transformation process. the aim of this study was showed that the application of evidence needs to be embedding in the real setting to construct the localization plan and achieve the effective result. Methods To establish evidence of the benefits of early postoperative off-bed activities on patients’ well-being based on a literature review. An interrupted time series analysis was used to evaluate the effectiveness of the intervention. The first and third periods were both five months (from February 1st, 2019 to January 31st, 2020), with a two-month interrupted time (from July 1st, 2019 to August 31st, 2019). Results Eight clinical practices were retrieved from the literature and incorporated into the intervention. A total of 465 patients were included: 226 patients before and 239 patients after implementing the intervention. The average onset time of postoperative off-bed activities was significantly earlier after the intervention than before the intervention (20.01 vs. 31.89 h after the operation, P < 0.001). The 24-h off-bed rate increased from 30.94% before to 91.21% after the intervention (P < 0.001). The average pain score of patients decreased from 5.23 points before to 3.82 points after the intervention (P = 0.032). The average postoperative hospital stay was shortened from 5.06 days before to 3.51 days after the intervention (P < 0.001). In addition, the incidence rates of postoperative ileus (POI) and infection decreased from 5.38% and 2.65% before to 1.67% and 0.84% after the intervention, respectively (P < 0.001). Conclusions We established an evidence-based nursing intervention. Evaluation of the effect of evidence-based practices should be considered in the clinical setting and include preoperative health education, effective analgesia management, and safety management.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study

et al. 2022

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“…8 .The study conducted by Akalper O et al,9 also shows similar results to our study, mean time to hear 1 st intestinal sounds after surgery in cases group is 12.6±7.7 hours and 16.3±5.2 hours in Control group with statistically significant difference between the groups.…”

supporting

confidence: 90%

A Randomized Interventional Study on Effect of Chewing Gum on Recovery of Gastrointestinal Functions in Postoperative Patients Following Abdominal Surgeries in the Department of Obstetrics and Gynecology, SMS Medical College, Jaipur

Suhana

Agrawal

Kant

2021

IJMBS

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Background: Post- operative gastrointestinal dysfunction is one of the complications following abdominal surgery which results in delayed return of bowel motility. It causes discomfort, prolonged hospital stay; hospital acquired infection and enhanced treatment cost. This study was conducted with an aim to analyze the clinical outcome of effect of chewing gum mainly to avoid post-operative gastrointestinal dysfunction and to compare the different gastrointestinal variables between cases and control group. Methods: In this study 80 patients were included, 40 Cases and 40. The cases were given chewing gum for duration of 15 minutes at 2nd , 4th and 6thhour of surgery. Bowel sound was auscultated at 3rd, 5th and 7th hour of surgery and outcomes were compared with control group. Control group were given only standard post-operative care. Results: Among cases Mean duration of 1st bowel sound appeared was 9.23±2.2 hours whie among control group was 15.99±3.48 hours and with operating time <1 hour is 5.1 ± 1.04 hours in cases and 6.2 ± .66 hours in control group while with operating time >1 hour it was 5.2 ± 1.03 hours cases and 6.3 ± 0.7 hours in control group. Mean duration of 1st flatus passed among cases was 13.3±2.24 hours while among control group was 26.62 ±2.6 hours and with operating time <1 hour was 13.8 ± 1.03 hours in cases and 16.25 ± 1.5 hours in control group, while it was 13.12 ± 1.96 hours in cases and 17.12 ± 1.5 hours in control group with operating time >1 hour. Mean duration of 1st motion passed among cases was 31.33±2.24 hours and was 44.62± 2.6 hours in control group and it was 48.8 ± 1.2 hours in cases and 50.7 ± 1.27 hours in control group with operating time <1 hour, while it was 48.8 ± 1.2 hours in cases and 51.1 ± 1.46 hours in control group with operating time >1 hour. Result was statistically significant P value (0.001).

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“…As an alternative to sham feeding, chewing gum had been proved to be an effective measure to ameliorate gastrointestinal function and decrease complications such as nausea, vomiting and ileus after gynecological surgery 21 . Another clinical study also indicated that chewing gum in the postoperative could shorten the duration of the intestinal movement, the time of first flatus and defecation time of patients who had undergone cesarean operation 22 . In our study, the data revealed that the first flatus time of the XBP group was similar to that of chewing gum group.…”

Section: Discussionmentioning

confidence: 97%

Effect of Xiangbin Prescription in Gastrointestinal Function After Gynecological Abdominal Surgery: a Randomized Controlled Trial

Lin

Zeng

et al. 2021

Preprint

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Background: Recovery of gastrointestinal function after gynecological abdominal surgery is a major clinical problem. An effective intervention to promote the rapid recovery of gastrointestinal function postoperatively is lacking. This randomized trial investigated whether Xiangbin prescription (XBP) was feasible in terms of efficacy and safety on gastrointestinal function recovery in patients after gynecological abdominal surgery. Methods: A randomized controlled study was conducted, in which 190 patients with gynecological abdominal surgery who met the inclusion and exclusion criteria were enrolled. They were assigned randomly to XBP group, chewing gum group or blank control group, and respectively received the following treatments: took the XBP twice a day, chewed a piece of gum for about 15 minutes each 4 hours, or received conventional western basic treatment, starting on postoperative day 1 until defecation. Three groups were compared in terms of primary outcomes including the time of the first defecation and the time of the first flatus and secondary outcomes including the level of Ghrelin (GHRL) and the incidence of postoperative complications. Meanwhile, the safety of this trial was evaluated. Results: There was no statistical difference in baseline characteristics among the three groups. For the time of the first flatus, XBP group (22.33 ± 6.68 h) showed less time compared with the chewing gum group (23.06 ± 7.37 h), while it was shorter than that in the blank control group (25.86 ± 7.93 h) with significant difference (P < 0.05). As for the time of the first defecation, XBP group (38.65 ± 12.96 h) showed shorter time significantly compared with both the chewing gum group (47.29 ± 14.50 h) and the blank control group (54.01 ± 20.32 h) (P < 0.05). For the postoperative GHRL levels, XBP group was higher than that in the chewing gum group with no significant difference and had more significant improvement of the GHRL levels at postoperative day 3 compared with the blank control group (P < 0.05). For postoperative complications, XBP group had lower incidence than the other two groups but with no significant difference. For safety evaluations, no serious adverse events occurred in the three groups. Conclusions: XBP could promote the recovery of gastrointestinal function after gynecological abdominal surgery and it is overall safe. Trial registration: This trial was retrospectively registered by Chinese Clinical Trial Registry with the identifier number, ChiCTR1900026327, at September 30, 2019. http://www.chictr.org.cn/.

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Gum chewing and bowel function after Caesarean section under spinal anesthesia

Cited by 9 publications

References 19 publications

Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study

Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study

A Randomized Interventional Study on Effect of Chewing Gum on Recovery of Gastrointestinal Functions in Postoperative Patients Following Abdominal Surgeries in the Department of Obstetrics and Gynecology, SMS Medical College, Jaipur

Effect of Xiangbin Prescription in Gastrointestinal Function After Gynecological Abdominal Surgery: a Randomized Controlled Trial

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