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Does mechanical massage of the abdominal wall after colectomy reduce postoperative pain and shorten the duration of ileus? Results of a randomized study.

Abstract
The aim of this study was to determine the effectiveness of mechanical abdominal massage on postoperative pain and ileus after colectomy. We hypothesized that parietal abdominal stimulation could counteract induced pain and postoperative ileus, through common spinal-sensitive pathways, with nociceptive visceral messages. After preoperative randomization, 25 patients (age 52 +/- 5 years) underwent active mechanical massage by intermittent negative pressure on the abdominal wall resulting in aspiration (Cellu M50 device, LPG, Valence, France), and 25 patients (age 60 +/- 6 years) did not receive active mechanical massage (placebo group). Massage sessions began the first day after colectomy and were performed daily until the seventh postoperative day. In the active-massage group, amplitude and frequency were used, which have been shown to be effective in reducing muscular pain, whereas in the placebo group, ineffective parameters were used. Visual analogue scale (VAS) pain scores, doses of analgesics (propacetamol), and delay between surgery and the time to first passage of flatus were assessed. Types and dosages of the anesthetic drugs and the duration of the surgical procedure did not differ between groups. From the second and third postoperative days, respectively, VAS pain scores (P < 0.001) and doses of analgesics (P < 0.05) were significantly lower in patients receiving active massage compared to the placebo group. Time to first passage of flatus was also significantly shorter in the active-massage group (1.8 +/- 0.3 days vs. 3.6 +/- 0.4 days, P < 0.01). No adverse effects were observed. These results suggest that mechanical massage of the abdominal wall may decrease postoperative pain and ileus after colectomy.
AuthorsIsabelle Le Blanc-Louvry, Bruno Costaglioli, Catherine Boulon, Anne-Marie Leroi, Philippe Ducrotte
JournalJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) 2002 Jan-Feb Vol. 6 Issue 1 Pg. 43-9 ISSN: 1091-255X [Print] United States
PMID11986017 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Analgesics
Topics
  • Abdominal Muscles (physiology)
  • Analgesics (administration & dosage)
  • Analysis of Variance
  • Colectomy (methods)
  • Female
  • Humans
  • Intestinal Obstruction (surgery)
  • Male
  • Massage (methods)
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative (drug therapy, rehabilitation)
  • Patient Satisfaction
  • Postoperative Period
  • Preoperative Care
  • Reference Values
  • Statistics, Nonparametric
  • Treatment Outcome

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