The Effects of the Thai Traditional Medicine of Abdominal Massage on Defecation in Post Lumbar Laminectomy Patients

Objective: This prospective study examined the defecation enhancement effects in post-lumbar laminectomy patients who received Thai traditional medicine of abdominal massage (TTMAM) in combination with standard nursing care, compared with patients receiving only standard nursing care. Methods: This prospective, randomized, controlled trial was conducted at Siriraj Hospital between 2011 and 2015. Eighty-eight patients with spinal stenosis scheduled for lumbar laminectomy with or without fusion were enrolled. The patients were randomly assigned to two groups: the first group underwent standard nursing care combined with TTMAM (the TTMAM group), and the second group underwent standard nursing care (the non-TTMAM group). The clinical outcomes regarding the first defecation within 3 days after surgery, abdominal distension, and patient satisfaction with defecation care were evaluated.  Results: When comparing the first defecation within 3 days after surgery, no significant differences were found in the number of patients between the two groups. The number of the patients who had their first defecation within 3 days after surgery was higher in the TTMAM group (46.5%) than the non-TTMAM group (27.3%). There was significantly less abdominal distension on the third day after surgery in the TTMAM group than in the non-TTMAM group. Moreover, the mean score of patient satisfaction of the TTMAM group was higher than that of the non-TTMAM group. Conclusion: Thai traditional medicine of abdominal massage tends to help defecation in post-lumbar laminectomy patients as it relieves abdominal distension and increases satisfaction with defecation care. Therefore, the use of TTMAM with other bowel care methods could provide additional benefit for lumbar laminectomy patients.