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Nausea, vomiting and return of bowel function after colorectal surgery
Author(s) -
Barclay Karen L.,
Zhu YingYan,
Tacey Mark A.
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13290
Subject(s) - medicine , vomiting , nausea , context (archaeology) , ileostomy , postoperative nausea and vomiting , odds ratio , confidence interval , anesthesia , surgery , hazard ratio , colorectal surgery , morphine , abdominal surgery , paleontology , biology
Background Although patterns of return of bowel function ( ROBF ) following colorectal surgery with enhanced recovery after surgery (ERAS) programmes have been well delineated, regular morphine use is uncommon. This study describes the patterns of post‐operative nausea and vomiting ( PONV ) and ROBF in this context. Method Patients undergoing elective major colorectal surgery on an ERAS programme over 1 year were included. Patient details, intra‐operative course, post‐operative management, outcomes and complications were collected retrospectively from clinical records. Statistical analysis was performed using S tata version 12. Results A total of 136/142 (96%) patients received morphine for post‐operative analgesia. Most (112/142, 79%) experienced either no vomiting (87/142, 61%) or small amounts (25/142, 18%). On average, patients without an ileostomy passed flatus and opened their bowels after 2.4 and 4.3 days, those with an ileostomy taking 1.5 and 2.1 days. Vomiting was not related to ROBF ( P = 0.370) or overall complications; wound complications (odds ratio ( OR ) = 8.1, 95% confidence interval ( CI ): 2.0–32.5), electrolyte abnormalities ( OR = 2.9, 95% CI : 1.2–7.1) and length of stay (hazard ratio = 1.3, 95% CI : 1.2–1.5) were related. Conclusion Most patients do not experience PONV in this context. ROBF is predictable without prolonged delays. This information could be used to allow confident early discharge and identify patients whose deviation from normal may indicate complications.