Effectiveness of lactulose syrup after cardiac surgery

van der Schaaf, Marike; Vermeulen, Hester; Storm-Versloot, Marja N; Goossens, Astrid; Simons, Robert; Eijsman, Léon

doi:10.1016/j.apnr.2003.10.005

« Previous Next »Applied Nursing Research
Volume 17, Issue 1 , Pages 48-54, February 2004

Effectiveness of lactulose syrup after cardiac surgery

Marike van der Schaaf, PT (Research Physiotherapist)
- Department of RehabilitationAcademic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Address reprint requests to M. van der Schaaf, PT, Department of Rehabilitation, A01-423, Academic Medical Center, University of Amsterdam, PO Box 226600, 1100, DD Amsterdam, The Netherlands
Hester Vermeulen, RN (Research Nurse)
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Marja N Storm-Versloot, RN (Research Nurse)
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Astrid Goossens, MSc, RN (Clinical Epidemiologist)
- Center for Clinical Practice Guidelines at the Department of Clinical Epidemiology and BiostatisticsAcademic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Robert Simons, RN (Nurse Director)
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Léon Eijsman, Prof Dr (Cardiothoracic Surgeon)
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Abstract

Dutch cardiac surgery centers lack consistency in management with respect to the prevention of postoperative constipation. Although not based on any evidence, the administration of lactulose syrup is widely used. Because it often causes intestinal discomfort such as abdominal pain, bowel cramps, and feelings of distention, a study was performed in postoperative cardiac surgery patients who were given either standard care (routine administration of lactulose syrup twice daily) or laxative on indication. Postoperative constipation appeared equally frequent in both groups, and patients who received lactulose had more symptoms of intestinal discomfort. Based on these findings, it is safe to abolish the routine management of postoperative laxatives on a cardiac surgery ward.