Effectiveness of lactulose syrup after cardiac surgery.
Dutch cardiac surgery centers lack consistency in management with respect to the prevention of postoperative constipation. Although not based on any evidence, the administration of lactulose syrup is widely used. Because it often causes intestinal discomfort such as abdominal pain, bowel cramps, and feelings of distention, a study was performed in postoperative cardiac surgery patients who were given either standard care (routine administration of lactulose syrup twice daily) or laxative on indication. Postoperative constipation appeared equally frequent in both groups, and patients who received lactulose had more symptoms of intestinal discomfort. Based on these findings, it is safe to abolish the routine management of postoperative laxatives on a cardiac surgery ward.
Department of Rehabilitation, A01-423 Academic Medical Center, University of Amsterdam, PO Box 226600, 1100 DD Amsterdam, The Netherlands. m.vanderschaaf@amc.uva.nl
Marike
M
van der Schaaf
Hester
H
Vermeulen
Marja N
MN
Storm-Versloot
Astrid
A
Goossens
Robert
R
Simons
Léon
L
Eijsman
D015746:Abdominal Pain / Q000139:chemically induced; D000046:Academic Medical Centers; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002985:Clinical Protocols; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D003672:Defecation; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007792:Lactulose / Q000009:adverse effects / Q000627:therapeutic use*; D009120:Muscle Cramp / Q000139:chemically induced; D009426:Netherlands; D009730:Nursing Assessment / Q000379:methods; D015403:Nursing Evaluation Research; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods / Q000451:nursing / Q000592:standards; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D007792:Lactulose