Use of Non-Pharmacological Methods to Increase Intestinal Functions After Abdominal Surgery: What Do Say Evidences?

Öz

Today, one of the most common problems faced by patients after abdominal surgery is gastrointestinal motility dysfunction. It occurs with signs and symptoms such as inability to pass gas, lack of bowel movement, abdominal pain, distention, nausea, vomiting, constipation in patients. Failure to control these symptoms early causes additional problems in patients such as fluid-electrolyte imbalance, delayed recovery, decreased comfort, prolonged hospital stay, and increased risk of hospital-acquired infection. Both pharmacological and non-pharmacological treatment methods are used to increase intestinal motility in the postoperative period. In the literature, it is stated that non-pharmacological methods such as early mobilization, chewing gum, early oral hydration (water, warm water, tea, coffee consumption) and hot application are effective in increasing intestinal motility. These methods are preferred for reasons such as being inexpensive, easy to apply, prevent drug side effects, and have no negative effects. In this review, studies with high evidence level regarding non-pharmacological methods used to increase bowel motility of patients after abdominal surgery are included. It is recommended that surgical nurses include evidence-based practices to increase gastrointestinal motility in nursing care and increase the number of randomized controlled clinical trials on the subject.

Anahtar Kelimeler

• Postoperative period
• gastrointestinal motility
• complementary medicine
• nursing care

Abdominal Cerrahi Sonrasında Bağırsak Fonksiyonlarını Artırmada Farmakolojik Olmayan Yöntemlerin Kullanımı: Kanıtlar Ne Diyor?

Öz

Günümüzde abdominal cerrahi sonrasında hastaların sıklıkla karşılaştığı sorunlardan biri gastrointestinal motilitede fonksiyon bozukluğudur. Hastalarda gaz çıkaramama, bağırsak hareketinin olmaması, karın ağrısı, distansiyon, bulantı, kusma, konstipasyon gibi belirti ve bulgularla ortaya çıkmaktadır. Bu semptomların erken sürede kontrol altına alınmaması hastalarda sıvı-elektrolit dengesizliği, iyileşmede gecikme, konforda azalma, hastanede yatış süresinde uzama, hastane kaynaklı enfeksiyon riskinin artması gibi ilave sorunlara neden olmaktadır. Ameliyat sonrası dönemde bağırsak motilitesini artırmada hem farmakolojik hem de farmakolojik olmayan tedavi yöntemleri kullanılmaktadır. Literatürde erken mobilizasyon, sakız çiğneme, erken oral hidrasyon (su, ılık su, çay, kahve tüketimi), sıcak uygulama gibi farmakolojik olmayan yöntemlerin bağırsak motilitesini arttırmada etkili olduğu yer almaktadır. Bu yöntemler ucuz olması, kolay uygulanabilmesi, ilaç yan etkilerini önlemesi, olumsuz etkilerinin olmaması gibi nedenlerle tercih edilmektedir. Bu derlemede, abdominal cerrahi sonrasında hastaların bağırsak motilitesini arttırmada kullanılan farmakolojik olmayan yöntemlere ilişkin kanıt düzeyi yüksek çalışmalara yer verilmiştir. Cerrahi hemşirelerinin gastrointestinal motiliteyi arttırmaya yönelik kanıta dayalı uygulamaları hemşirelik bakımına dahil etmeleri ve konuya ilişkin randomize kontrollü klinik çalışmaların artırılması önerilmektedir. 

Anahtar Kelimeler

• Ameliyat sonrası dönem
• gastrointestinal motilite
• tamamlayıcı tıp
• hemşirelik bakımı

Kaynakça

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