RESUMO
Background: Postoperative ileus (POI) is a common complication following caesarean section. It impairs patients comfort; delays wound healing and prolong duration of hospital stay. Several methods have been used in the management of this condition with varying efficacy. Chewing gum postoperatively is a recent concept in the western world being advocated as a cost effective and comfortable management of POI.Aim: The aim was to evaluate the efficacy of gumchewing in reducing POI following caesarean section in Enugu.Materials and Methods: One hundred and eighty women booked for elective caesarean section were randomized into gumchewing group (n = 90) or control group (n = 90) The subjects chewed sugarless gum three times daily from 6 h postoperatively until the first passage of flatus. Each chewing session lasted 30 min. Elective cesarean section was carried out with a Pfannenstiel incision. Groups were compared primarily for time to first bowel sound, and first flatus.Secondary endpoints of comparison were time of operation to first defecation, and patient satisfaction concerning postoperative gum chewing. The Student's ttest and Pearson Chisquare test and multiple linear regression were used for statistical analysis.Results: The groups were comparable in age, body mass index (BMI) and duration of surgery. The mean time to first bowel sounds (21.9 ± 8.0 vs. 26.1 ± 10.0), mean time to first flatus (24.8 ± 6.4 vs. 30.0 ± 10.0) and mean time to defecation (30.7 ± 5.9 vs. 40.0 ± 9.0) were significantly reduced in patients that chewed gum compared with controls.P =0.02, 0.01, and 0.01, respectively. Patients were satisfied with gum chewing and no sideeffect was recorded.Previous surgery and duration of surgery were predictors on duration of POI, while age, BMI and parity had no effect.Conclusion: Gumchewing has a beneficial effect on early return of bowel function following cesarean section and should be included in the postoperative management protocol
Assuntos
Cesárea , Goma de Mascar , Íleus , NigériaRESUMO
Background: Pre-anaesthetic evaluation is a basic component of safe anaesthetic practice and ends with the establishment of an anaesthetic plan of action for individual patients. Objectives: The aim of the present study was to assess the difficulties encountered by the anaesthetist during such visits and suggest ways they can be overcome Subjects and Methods: The `activity book' of anaesthetic resident doctors in the hospital was reviewed retrospectively for documented problems they encountered during the pre-operative visit. The problems listed were then subjected to analysis using the SPSS 17. Result: The commonest problem was the unavailability of the patient for review 73.1followed by very busy schedule (7.4) and unfit patients (6.9) Conclusion: Anaesthetists still do encounter problems during the pre-operative visit. Exposing such problems creates the necessary awareness for improvement of patient care