Early Oral Feeding vs Traditional Post-operative Care In Emergency Abdominal Surgeries

College of Physicians and Surgeons Pakistan

Status: Completed

Conditions: Perforated Duodenal Ulcer

Treatments: Dietary Supplement: Early oral feeding/Enhanced recovery after surgery protocols

Study type: Interventional

Funder types: Other

Identifiers

NCT04431037

pdu

Details and patient eligibility

About

ABSTRACT BACKGROUND: Enhanced recovery after surgery (ERAS) protocols have been widely studied in elective abdominal surgeries and have shown better outcomes. However the utility of these protocols in emergency abdominal surgeries has not been widely investigated.

OBJECTIVE: To study the outcomes of application of ERAS protocols in patients undergoing perforated duodenal ulcers repairs in emergency abdominal surgeries.

METHODS: This randomized controlled trial was conducted in Surgical Unit 1 BBH from August 2018 to December 2019 with a total sample size of 36 patients with the diagnosis of perforated duodenal ulcer. Patients were randomly divided in two groups. Group A consisted of early oral feeding group and group B consisted of traditional postoperative care group. Outcome results studied were the length of hospital stay, duodenal repair site leak, severity of pain (VAS score) and duration of post-operative ileus. Results were analysed on SPSS version 20 and chi-square and independent t-test were applied.

KEY WORDS: Perforated duodenal ulcer, ERAS protocol, randomized controlled trial, duodenal repair site leak, length of hospital stay, VAS score, post-operative ileus

Enrollment: 36 patients

Sex: All

Ages: 15 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All patients older than 15 years with acute abdominal symptoms admitted in ER department, suspected as perforated duodenal ulcer and operated within 24 hours of admission by emergency department surgeon.

Exclusion criteria

• Patients presenting with the following criteria were excluded:
• Refusal to join the study
• Peptic ulcers with both bleeding and perforation.
• Spontaneously sealed off perforations.
• Malignant ulcers
• Concurrent extra-abdominal surgery
• Oral incapacity i.e endotracheal intubation
• Reoperation within a month
• ASA grade III/IV
• Alternative per operative diagnosis.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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36 participants in 2 patient groups

Early oral feeding group(A)

Experimental group

Description:

Patients admitted in the HDU postoperatively.NG tube and foley's catheter removed within 12 hours and patients allowed oral sips on day 1 with gradual shift to liquid diet after 12 hrs and semisolid food started after 24 hours later.Patients were given i/v antibiotics,painkillers and i/v PPIs and shifted to oral pain killers on 2nd POD.

Treatment:

Dietary Supplement: Early oral feeding/Enhanced recovery after surgery protocols

Traditional postoperative care group(B)

No Intervention group

Description:

Patients in this group were managed traditionally