Effects Of Mouth Dissolving Mosapride Tablets (Mdmts) On Gut Recovery After Major Abdominal Gynecological Surgery (Mags)

Aim. To access whether receiving mouth dissolving mosaperide tablets (MDMTs) in immediate postoperative period in addition to routine care accelerates the recovery of upper and lower gastrointestinal function after major abdominal gynecological surgery (MAGS).
Patients & Methods: A randomized controlled study was conducted from December 2014 to December 2015. Patients scheduled to undergo abdominal hysterectomy were assigned to receive MDMTs beside routine care immediately postoperatively or routine care alone after surgery. patient's postoperative charts were reviewed to establish incidence of postoperative nausea, vomiting, use of analgesics, use of antiemetics, cases developing postoperative ileus (P01) (nausea, vomiting, distention, absence of bowel sounds) and its degree mild (resolved spontaneously on basic support), moderate (required nasogastric tube insertion beside basic support), severe (POI that resist management lines including antiemetic and persist for > 2 days), time to discharge and time from end of surgery to first postoperative hearing intestinal sounds, toleration of fluids intake, toleration to solid foods intake, passage of flatus, as well as first defecation.
Results: A total of 120 patients were randomly assigned to receive MDMTs (n=60, 2 were excluded, 58 were available for intension to treat analysis) or routine postoperative care alone (n =60, 4 were excluded, 56 were available for intension to treat analysis). The mean time to first hunger, toleration of liquids and solids, bowel movement, flatus as well as first defecation were significantly shorter in participants whom assigned to receive MDMTs (P = 0002, P = 0.027, P < 0.0001, P = 0.0001, P < 0.000, P = 0.0006 respectively). Participants assigned to receiving MDMTs than routine care experienced significant postoperative nausea (P = 0.004) vomiting (P = 0.005) and mild and moderate POI (P = 0.008, P = 0.02 respectively). MDMTs intake was well tolerated and well accepted by patients and no intervention — related side effects were observed.
Conclusion: Receiving MDMTs after MAGS accelerates the time of gut recovery, shortened the length of hospital stay as well as reduce the incidence of POI. This simple, inexpensive and well tolerated treatment could be added to routine postoperative care of major gynecological abdominal surgery patients.