Does postoperative misoprostol use induce intestinal motility? A prospective randomised double-blind trial.
BACKGROUND
Misoprostol has been shown to increase colonic activity and decrease colonic transit time in chronic constipation patients.


OBJECTIVE
The aim of this prospective, randomised, double-blind study was to examine the effectiveness of rectally administered misoprostol on inducing intestinal motility after gynaecological surgery.


METHODS
Eighty women who underwent hysterectomy were divided randomly into three groups. Group A received misoprostol 200 microg rectally while group B received 400 microg rectal misoprostol after surgery before leaving the operating room. Patients in group C received no drugs. Bowel sounds in four quadrants were checked every hour and possible side-effects of misoprostol like nausea, vomiting, and distension were evaluated. The time interval between surgery and flatus pass and the need of analgesics were noted. Statistical analyses were done with Mann-Whitney U-test and chi2 tests where available.


RESULTS
The time between surgery and presence of bowel sounds in four quadrants were similar in all groups (2.7 +/- 1.6, 2.9 +/- 1.2, 2.8 +/- 1.3 h, for groups A, B, and C, respectively). No difference was observed in flatus pass time. The incidence of nausea was significantly increased in group B compared to controls (P < 0.01). Additional analgesic need was significantly higher in groups A and B when compared to controls (P < 0.05 and P < 0.01, for groups A and B, respectively).


CONCLUSIONS
Rectally administered misoprostol does not improve intestinal motility in the early postoperative period and thus, it is not effective in providing early oral food intake. On the contrary, it causes distention that requires additional analgesics and vomiting that naturally limits oral diet intake.
Demirci
Fuat
F
Department of Obstetrics and Gynecology, School of Medicine, Duzce University, Duzce, Turkey.
Somunkiran
Asli
A
Gul
Ozlem Kemik
OK
Demiraran
Yavuz
Y
Ozdemir
Ismail
I
Gul
Ozgur Baris
OB
D000285:Administration, Rectal; D000328:Adult; D004311:Double-Blind Method; D004435:Eating; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007044:Hysterectomy / Q000534:rehabilitation*; D007902:Length of Stay; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage / Q000494:pharmacology*; D011182:Postoperative Care; D011446:Prospective Studies; D013997:Time Factors
D016595:Misoprostol