Effect of Gum Chewing to Reduce Postoperative Ileus Following Anatrophic Nephrolithotomy or Nephrectomy

บทคัดย่อ

           The purpose of this experimental research was to study the effect of gum chewing to reduce postoperative ileus following anatrophic nephrolithotomy or nephrectomy. The conceptual framework of this study was based on gum chewing, a type of sham feeding, may stimulate gut motility via cephalic vagal stimulation, and thereby reduce the duration of ileus. The sample of this study consisted of 60 patients who underwent anatrophic nephrolithotomy or nephrectomy and were admitted in Urology ward, Khon Kaen Hospital. The samples were equally divided into two groups: the experimental and control groups. The control group (n= 30) received routine postoperative care and those in the experimental group (n= 30) received the immediate use of gum chewing when regained consciousness in the first postoperative day, chewing gum 3 times for 30 minutes each after breakfast, lunch, and dinner with a piece of gum, for 2 days after operation. The instruments used in this study consisted of demographic data form and postoperative ileus assessment. A reliability of this instrument equaled 0.9 (Cronbach’ alpha coeffcient). The study were conducted from April to October 2008. The data were analyzed with chi - square test, and Fisher’s exact test. The result revealed that the subjects in the experimental group had normal passed flatus, belching on the first post operative day and the third post operative day in control group, with a statistically difference significant (p < 0.05). The experimental group had normal bowel sound on the second post operative day and the fourth post operative day in control group, with a statistically difference (p < 0.05) and had required significanthy less medical treatment to reduce postoperative ileus lower than the control group, with a statistically significant difference significant (p < 0.05). In conclusion gum chewing could reduce postoperative ileus. It is recommended that nurses should apply gum chewing to reduce postoperative ileus in another renal surgery, or in abdominal surgery.

Key words: anatrophic nephrolithotomy, nephrectomy, gum chewing, postoperative ileus