title: Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized study.
abstract: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Laxative improves recovery of gastrointestinal function after fast-track hysterectomy but has no significant effect on pain and PONV.
authors.affiliation: Department of Gynecology and Obstetrics, Hvidovre University Hospital, Copenhagen, Denmark.
authors.forename: Charlotte T
authors.initials: CT
authors.lastname: Hansen
authors.forename: Mette
authors.initials: M
authors.lastname: Sørensen
authors.forename: Charlotte
authors.initials: C
authors.lastname: Møller
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.forename: Henrik
authors.initials: H
authors.lastname: Kehlet
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002400:Cathartics / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D011184:Postoperative Period; D011336:Probability; D020127:Recovery of Function; D012016:Reference Values; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002400:Cathartics