Rib Raising for Post-operative Ileus

Rutgers The State University of New Jersey

Status: Completed

Conditions: Postoperative Complications; Intestinal Pseudo-Obstruction; Manipulation, Osteopathic; Postoperative Care; Postoperative Nausea and Vomiting; Osteopathic Medicine

Treatments: Procedure: Rib raising and lumbar release; Procedure: Sham procedure

Study type: Interventional

Funder types: Other

Identifiers

NCT03662672

Pro2018001548

Details and patient eligibility

About

We are conducting a randomized controlled trial the use of rib raising for post-operative ileus. Rib raising is an osteopathic manipulative technique (OMT). We will recruit all patients undergoing major abdominal surgery and once they have been enrolled, we will randomize them to receive daily rib raising or a control technique where we place hands on the back but do not apply any pressure. In preliminary studies, Rib raising has been shown to reduce post-operative ileus and hospital length of stay by up to 50%.

Enrollment: 102 patients

Sex: All

Ages: 18 to 69 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Major abdominal surgery (laparotomy, laparoscopy excluding simple laparoscopic appendectomy or laparoscopic cholecystectomy)

Exclusion criteria

• Open abdomen for >72 hours
• Prior history of major post-operative complications
• Intolerance to anesthesia
• Co-morbidities including osteoporosis and osteopenia
• Spine or rib fractures
• Pregnancy
• Prisoners
• History of osteopathic manipulation
• Recruitment delayed beyond 48 hours
• Surgeon requested exclusion

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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102 participants in 2 patient groups

Rib-raising Intervention

Experimental group

Description:

We will do daily rib raising and lumbar release from the 5th thoracic vertebra to the 2nd lumbar vertebra for 2 minutes per side for rib raising and 2 minutes for lumbar release.

Treatment:

Procedure: Rib raising and lumbar release

Sham Intervention

Sham Comparator group

Description:

We will do daily sham intervention from the 5th thoracic vertebra to the 2nd lumbar vertebra where we place our hands under the ribs for 2 minutes per side and under the lumbar area for 2 minutes without applying any pressure (or applying pressure into the bed).

Treatment:

Procedure: Sham procedure