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

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  • Chen Yue
  • Youwen Liu
  • Xue Zhang
  • Bin Xu
  • Hongfeng Sheng

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.

Suggested Citation

  • Chen Yue & Youwen Liu & Xue Zhang & Bin Xu & Hongfeng Sheng, 2020. "Randomised controlled trial of a comprehensive protocol for preventing constipation following total hip arthroplasty," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(15-16), pages 2863-2871, August.
    • Handle: RePEc:wly:jocnur:v:29:y:2020:i:15-16:p:2863-2871
    DOI: 10.1111/jocn.15299
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    References listed on IDEAS

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    1. Lingping Zhu & Yunhui Ma & Xiaoyan Deng, 2018. "Comparison of acupuncture and other drugs for chronic constipation: A network meta-analysis," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-15, April.
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    1. Mahinur Durmuş İskender & Nurcan Çalışkan, 2022. "Effect of Acupressure and Abdominal Massage on Constipation in Patients with Total Knee Arthroplasty: A Randomized Controlled Study," Clinical Nursing Research, , vol. 31(3), pages 453-462, March.

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