Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized study

OBJECTIVE: The purpose of this study was to determine the effect of early oral bowel stimulation with osmotic laxatives on gastrointestinal function, postoperative nausea and vomiting ( PONV) and pain in patients who undergo fast-track abdominal hysterectomy. STUDY DESIGN: This was a double-blind, placebo-controlled study of 53 women who were assigned randomly to either laxative ( magnesium oxide + disodium phosphate) or placebo that was initiated 6 hours after the operation. Primary outcome was time to first defecation; the number of vomiting episodes; nausea and pain score were assessed on a visual analogue scale. RESULTS: Time to first postoperative defecation was a median of 45 hours in the laxative group and a median of 69 hours in the placebo group ( P = .0001). There were no significant differences between groups in pain scores, PONV and the use of morphine or antiemetics. Postoperative hospitalization was a median of 1 day in the laxative group and of 2 days in the placebo group (P = .41). CONCLUSION: Laxative improves recovery of gastrointestinal function after fast-track hysterectomy but has no significant effect on pain and PONV.