The effect of ambulation on recovery from postoperative ileus.
To determine whether ambulation hastens recovery from ileus following laparotomy, 34 patients were studied, 10 of whom followed an ambulatory regimen beginning on postoperative day 1 (group A). The other 24 patients (group C) did not become ambulatory until postoperative day 4. All patients underwent placement of seromuscular bipolar recording electrodes on the Roux limb, if present, stomach, jejunum, and colon at laparotomy. Group A was recorded before and after ambulation so comparisons could be made to determine if ambulation had an acute effect on myoelectric activity. Group A preambulation and group C recordings were compared to judge whether there was an over-all effect of ambulation on myoelectric recovery. No effect on slow wave frequency or percentage of slow waves with associated spike potentials was noted acutely or overall in the stomach, colon, or jejunum in continuity with the duodenal pacemaker. Transient increases in phase II spike activity in patients having a Roux limb and their jejunum distal to the enteroenterostomy were noted on postoperative days 1 to 2, but these differences resolved by postoperative days 3 or 4. The data suggest that ambulation as a means to help resolve postoperative ileus and its accompanying cramps and bloating may be more perceived than real.
Waldhausen
J H
JH
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Schirmer
B D
BD
D000713:Anastomosis, Roux-en-Y; D003106:Colon / Q000503:physiopathology; D004434:Early Ambulation; D004567:Electrodes, Implanted; D004576:Electromyography / Q000295:instrumentation; D004766:Enterostomy; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007415:Intestinal Obstruction / Q000517:prevention & control*; D007583:Jejunum / Q000503:physiopathology; D008564:Membrane Potentials / Q000502:physiology; D011183:Postoperative Complications / Q000517:prevention & control*; D013270:Stomach / Q000503:physiopathology; D013997:Time Factors