Factors which delay recovery following uncomplicated abdominal surgery include uncontrolled pain, intolerance of diet and poor mobility. Enhanced recovery after Surgery (ERAS) programmes are perioperative care pathways that address systematically these issues (i.e. improved dynamic pain relief, optimised nutritional care and enforced mobilisation) to promote a faster recovery and a shorter stay. The key treatments that improve outcome within an ERAS programme are not known. Moreover there are few acceptable, objective endpoints to assess key outcome variables such as return of GI function. This randomised trial will assess the potential synergy between early recovery of GI function (laxation) and early postoperative oral nutritional support(with associated preoperative preconditioning using carbohydrate/fluid loading). The main overall outcome targets being improved recovery of gastrointestinal function, postoperative nutritional status and physical function. It will validate the use of a novel, objective technique to measure gastric motility (surrogate for GI function). Such refinement of ERAS should result in shorter hospital stay and better use of limited health care resource.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
64
20 ml of Magnesium Oxide twice daily from the day after surgery until discharge
Nutricia PreOP drinks 800 ml between 8-10 pm the evening before surgery Nutricia PreOP drinks 400 ml completed 2 hours before anaesthesia on the morning of surgery Nutricia Fortisip drinks 2 x 200 ml drinks from the day after surgery until day 30
University Hospital Maastricht
Maastricht, Netherlands
Edinburgh Royal Infirmary
Edinburgh, United Kingdom
Recovery of gastrointestinal function: Time to pass flatus/stool (hours following the end of surgery)
Time frame: Number of hours post surgery
t ½ Gastric emptying time on the morning of post-operative day 3
Time frame: Postoperative day 3
Length of hospital stay: nights spent in hospital post-op
Time frame: Until discharge
Patient activity level: measured by activPAL® activity meter
Time frame: postoperative day 2 - 7 and day 30 - 37
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