Randomized Clinical Trial of Bisacodyl Versus Placebo on Postoperative Bowel Motility in Elective Colorectal Surgery

NCT ID: NCT00509327

Last Updated: 2007-07-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-11-30

Study Completion Date

2007-02-28

Brief Summary

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Postoperative bowel dysmotility is a frequent condition after colorectal surgery. The influence of colon stimulating laxatives have not been studied. This prospective, randomized, double blind, placebo controlled study assesses the influence of bisacodyl on postoperative bowel motility in patients undergoing elective colorectal surgery. The hypothesis of this trial was that bisacodyl has a beneficial effect on the duration of postoperative ileus.

Detailed Description

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All adult (\>18 years) patients admitted for elective colorectal resection were evaluated for eligibility.

Patients were randomized using a computer programme and received either 10mg of bisacodyl in non-transparent capsules or identical placebo capsules, containing glucosemonohydricum. The capsules were administered twice daily, starting one day before surgery and ending on postoperative day three.Patients and all involved medical personnel were blinded.

Bowel preparation was not routinely used in open surgery, whereas in patients undergoing laparoscopic resection two litres of sodium-sulfate / macrogol solution (Cololyt®, Spirig Pharma AG, Switzerland) was administered. Standard colorectal surgery was performed in all patients. In open surgery a midline incision was used for laparotomy. In laparoscopic resections a four-port technique with removal of the specimen through a small transverse incision in the lower abdomen was used. All patients received perioperative single shot antibiotics, cefuroxime 1.5 g and metronidazole 1g. Nasogastric tube (NGT) was scheduled to be removed at the end of surgery. Postoperative treatment was not changed during the study. All patients received postoperatively a basic analgesia of 500 to 1000 mg oral paracetamol every 6 h; additionally, metamizol was administrated intravenously or orally as needed.

The primary endpoint was the time to recovery of gastrointestinal function, defined as the mean time to the occurrence of the following three events (GI-3): first flatus passed, first defecation and first solid food tolerated. We did not include the presence of bowel movement, as they may be present before recovery of the colon due to small bowel activity24. Secondary endpoints were the incidence of NGT reinsertion, duration of NGS reinsertion, incidence of postoperative vomiting and length of hospital stay. Additionally, consumption of analgesics and pain, cramping and nausea scores (assessed with a visual analogue scale \[VAS\]) during the first 8 postoperative days were monitored. Other variables recorded were patients' demographics, use of epidural anaesthesia, type and duration of surgery and morbidity.

Conditions

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Postoperative Ileus

Keywords

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postoperative ileus colorectal surgery bisacodyl laxatives

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Study Groups

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1

bisacodyl 10mg twice daily from one day preoperative to day three postoperative

Group Type ACTIVE_COMPARATOR

bisacodyl

Intervention Type DRUG

10mg capsule twice daily from one day preoperatively to day three postoperatively

2

10mg of glucosemonohydricum twice daily from one day preoperative to day three postoperative

Group Type PLACEBO_COMPARATOR

glucosemonohydricum

Intervention Type DRUG

10mg of glucosemonohydricum twice daily from one day preoperative to day three postoperative

Interventions

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bisacodyl

10mg capsule twice daily from one day preoperatively to day three postoperatively

Intervention Type DRUG

glucosemonohydricum

10mg of glucosemonohydricum twice daily from one day preoperative to day three postoperative

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* elective colorectal resection
* age \>18 years

Exclusion Criteria

* preoperatively planned stoma formation
* emergency surgery
* pregnancy
* known hypersensitivity for bisacodyl
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Basel, Switzerland

OTHER

Sponsor Role lead

Principal Investigators

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Urs Zingg, MD

Role: PRINCIPAL_INVESTIGATOR

department of Surgery, University Hospital Basel, Switzerland

Urs Metzger, Professor

Role: STUDY_DIRECTOR

Triemli Hospital, Zurich, Switzerland

Locations

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Department of Surgery, Triemli Hospital, Zurich, Switzerland

Zurich, , Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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2004DR4256

Identifier Type: -

Identifier Source: org_study_id