The use of a prophylactic laxative to reduce gastrointestinal discomfort following open heart surgery

2.50
Hdl Handle:
http://hdl.handle.net/10755/148486
Type:
Presentation
Title:
The use of a prophylactic laxative to reduce gastrointestinal discomfort following open heart surgery
Abstract:
The use of a prophylactic laxative to reduce gastrointestinal discomfort following open heart surgery
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Boley, Theresa, BSN/BN
P.I. Institution Name:University of Missouri
Title:Research Associate
The primary concern when caring for patients who have had recent

open-heart surgery is maintenance of an optimum hemodynamic state

However, all of a patients' physiologic needs should be assessed

and managed, including the promotion of normal bowel activity.

Standing orders or prescriptions are commonly used to promote

return of bowel evacuation (BE) and reduce gastrointestional

discomfort (GD). We wished to test the hypothesis: Subjects

receiving the PL magnesium hydroxide (Milk of Magnesia) will

experience less GD than subjects who do not receive a PL. The

reduction was measured by a more rapid resumption of bowel

evacuation and by the patient scoring of a visual analogue and

graphic rating scale. 150 open heart surgery patientss met the study

criteria. Sixty-eight were randomized to the experimental group

(EG) and 82 to the control (C). The EG received 20 ml concentrated

Milk of Magnesia and the C received 10 cc of water <= 36 hours

postoperatively. Chi-Square or Wilcoxon rank sum tests were used

for statistical analyses. The significance level was set at .01.

The groups were homogeneous for age, sex and surgical procedure.

The mean age was 63.8 years in the EG and 64.7 years in the C

(p=.5826). The female/male ratio was 17/51 in the EG and 17/65

in the C (p=.567). There was no significant difference in the

number of bypass grafts (3.3 EG, 3.7 C; p=.505) or complex

procedures (16/68 EG, 6/82 C; p=.885). The amount of motility

altering drugs was similar between groups. Morphine sulfate prior

to the first BE was 16.39 mean mg in the EG and 22.28 mean mg in the

C (p=.1552). The mean number of acetaminophen with codeine tablets

was 9.61 in the EG and 8.44 in the C (p=.5403). Subjects in the EG

received 62.43 mean cc of antacids prior to the first BE compared

with 66.83 mean cc in the C (p=.5782). The administration of the PL

did not hasten BE (93 mean hours experimental group and 87 mean hours

control, p=.3719) or reduce GD as measured by a visual analogue and

graphic rating scale (28 mean mm experimental and 29 mean mm control,

p=9940). Potential effects of the treatment were similar between

groups. Bowel sounds resumed at 22.7 mean hours in the EG and 21.0

mean hours in the C (p=.3130). Twenty-four/68 in the EG and 41/82 in

the C had postoperative nausea (p=.070). Nine/68 in the EG and 22/82

in the C experienced vomiting (p=.041). Unnecessary use of PL

increases patient cost and nursing time. The use of PL should be

based on applied clinical research.



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe use of a prophylactic laxative to reduce gastrointestinal discomfort following open heart surgeryen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148486-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The use of a prophylactic laxative to reduce gastrointestinal discomfort following open heart surgery</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Boley, Theresa, BSN/BN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Missouri</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Research Associate</td></tr><tr><td colspan="2" class="item-abstract">The primary concern when caring for patients who have had recent<br/><br/>open-heart surgery is maintenance of an optimum hemodynamic state<br/><br/>However, all of a patients' physiologic needs should be assessed<br/><br/>and managed, including the promotion of normal bowel activity.<br/><br/>Standing orders or prescriptions are commonly used to promote<br/><br/>return of bowel evacuation (BE) and reduce gastrointestional<br/><br/>discomfort (GD). We wished to test the hypothesis: Subjects<br/><br/>receiving the PL magnesium hydroxide (Milk of Magnesia) will<br/><br/>experience less GD than subjects who do not receive a PL. The<br/><br/>reduction was measured by a more rapid resumption of bowel<br/><br/>evacuation and by the patient scoring of a visual analogue and<br/><br/>graphic rating scale. 150 open heart surgery patientss met the study<br/><br/>criteria. Sixty-eight were randomized to the experimental group<br/><br/>(EG) and 82 to the control (C). The EG received 20 ml concentrated<br/><br/>Milk of Magnesia and the C received 10 cc of water &lt;= 36 hours<br/><br/>postoperatively. Chi-Square or Wilcoxon rank sum tests were used<br/><br/>for statistical analyses. The significance level was set at .01.<br/><br/>The groups were homogeneous for age, sex and surgical procedure.<br/><br/>The mean age was 63.8 years in the EG and 64.7 years in the C<br/><br/>(p=.5826). The female/male ratio was 17/51 in the EG and 17/65<br/><br/>in the C (p=.567). There was no significant difference in the<br/><br/>number of bypass grafts (3.3 EG, 3.7 C; p=.505) or complex<br/><br/>procedures (16/68 EG, 6/82 C; p=.885). The amount of motility<br/><br/>altering drugs was similar between groups. Morphine sulfate prior<br/><br/>to the first BE was 16.39 mean mg in the EG and 22.28 mean mg in the<br/><br/>C (p=.1552). The mean number of acetaminophen with codeine tablets<br/><br/>was 9.61 in the EG and 8.44 in the C (p=.5403). Subjects in the EG<br/><br/>received 62.43 mean cc of antacids prior to the first BE compared<br/><br/>with 66.83 mean cc in the C (p=.5782). The administration of the PL<br/><br/>did not hasten BE (93 mean hours experimental group and 87 mean hours<br/><br/>control, p=.3719) or reduce GD as measured by a visual analogue and<br/><br/>graphic rating scale (28 mean mm experimental and 29 mean mm control,<br/><br/>p=9940). Potential effects of the treatment were similar between<br/><br/>groups. Bowel sounds resumed at 22.7 mean hours in the EG and 21.0<br/><br/>mean hours in the C (p=.3130). Twenty-four/68 in the EG and 41/82 in<br/><br/>the C had postoperative nausea (p=.070). Nine/68 in the EG and 22/82<br/><br/>in the C experienced vomiting (p=.041). Unnecessary use of PL<br/><br/>increases patient cost and nursing time. The use of PL should be<br/><br/>based on applied clinical research.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T09:45:53Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:45:53Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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