ARE ENEMAS GIVEN BEFORE ABDOMINAL OPERATIONS USEFUL - A PROSPECTIVE RANDOMIZED TRIAL

Objective: To assess the effect of preoperative enemas on the recovery of peristalsis after non-colonic abdominal operations. Design: Prospe ctive randomised trial. Setting: University hospital, Switzerland. Sub jects: 116 adult patients (>16 year old) about to undergo elective non -colonic abdominal operations under general anaesthaesia were consider ed. Intervention: Two groups were randomised to receive a one litre wa ter and glycerine enema the day before operation (n = 53) or no preope rative intestinal preparation (n = 53). Main outcome measures: Return of peristalsis after operation, assessed by auscultation of bowel soun ds and time of the first spontaneous faeces. All participants were fol lowed daily for 10 days or until discharge by the same observer.Result s: 110 patients gave informed consent, 6 refused to participate, and 4 had to be withdrawn after randomisation, leaving 106 for analysis. Th e patients without an enema recovered bowel sounds activity sooner (p = 0.02) and passed their first spontaneous faeces significantly earlie r (p = 0.01). No subgroup of patients benefited from an enema. Conclus ion: Preoperative enemas delay rather than improve the return of norma l peristalsis after surgery. We recommend this practice should be aban doned.