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Randomised controlled trial of a comprehensive protocol for preventing constipation following total hip arthroplasty.

Abstract：

AIMS AND OBJECTIVES:To evaluate the efficacy and safety of a comprehensive protocol for constipation prevention. BACKGROUND:Constipation is a common problem for patients undergoing total hip arthroplasty (THA), yet sparse evidence is available to guide constipation prevention after THA. DESIGN:Randomised controlled superiority clinical trial. METHODS:This randomised controlled study was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). A total of 80 THA patients were randomised to receive only preoperative education about lifestyle or the combination of education with postoperative abdominal massage and polyethylene glycol 4,000 (Forlax®). Efficacy outcomes included rates of postoperative constipation and enema rescue, as well as time to first postoperative defecation and readmission within 30 days. Safety outcomes were number and type of adverse events. RESULTS:Patients who received combination treatment showed a significantly lower rate of postoperative constipation during hospitalisation than patients who received only preoperative education (25% versus 55%), and they showed a significantly lower rate of enema rescue (12.5% versus 40%). Many more patients receiving combination treatment experienced their first defecation within two postoperative days than patients who received only preoperative education (62.5% versus 35.9%). In contrast, the two groups were similar in terms of constipation rate on postoperative days 15 and 30, rate of readmission within 30 days and rate of postoperative adverse events. CONCLUSIONS:These results suggest that our comprehensive protocol can relieve constipation after THA, reduce the need for enema rescue and shorten time to first defecation without sacrificing safety. More work is needed to optimise and develop this protocol further. RELEVANCE TO CLINICAL PRACTICE:Constipation is a distressing problem that frequently occurs after THA. This study confirmed that a comprehensive protocol including preoperative education, postoperative abdominal massage and polyethylene glycol 4,000 can effectively relieve constipation after THA without sacrificing safety.

journal_name

J Clin Nurs

journal_title

Journal of clinical nursing

authors

Yue C,Liu Y,Zhang X,Xu B,Sheng H

doi

10.1111/jocn.15299

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

2863-2871

issue

15-16

eissn

0962-1067

issn

1365-2702

journal_volume

pub_type

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Randomised controlled trial of a comprehensive protocol for preventing constipation following total hip arthroplasty.