HOMEOPATHY FOR POSTOPERATIVE ILEUS - A METAANALYSIS

`Homeopathic remedies are advocated for the treatment of postoperative ileus, yet data from clinical trials are inconclusive. We therefore p erformed meta-analyses of existing clinical trials to determine whethe r homeopathic treatment has any greater effect than placebo administra tion on the restoration of intestinal peristalsis in patients after ab dominal or gynecologic surgery. We conducted systematic literature sea rches to identify relevant clinical trials. Meta-analyses were conduct ed using RevMan software. Separate meta-analyses sere conducted for an y homeopathic treatment versus placebo; homeopathic remedies of <12C p otency versus placebo, homeopathic remedies of greater than or equal t o 12C potency versus placebo. A ''sensitivity analysis'' was performed to test the effect of excluding studies of low methodologic quality. Our endpoint was time to first flatus. Meta-analyses indicated a stati stically significant (p < 0.05) weighted mean difference (WMD) in favo r of homeopathy (compared with placebo) on the time to first flatus. M eta-analyses of the three studies that compared homeopathic remedies g reater than or equal to 12C versus placebo showed no significant diffe rence (p > 0.05). Meta-analyses of studies comparing homeopathic remed ies <12C with placebo indicated a statistically significant (p < 0.05) WMD in favor of homeopathy on the time to first flatus. Excluding met hodologically weak trials did not substantially change any of the resu lts. There is evidence that homeopathic treatment can reduce the durat ion of ileus after abdominal or gynecologic surgery. However, several caveats preclude a definitive judgment. These results should form the basis of a randomized controlled trial to resolve the issue.