Clinical trial NCT06196138: The Effect of Chewing Gum and Hot Compresses on Gynecologic Oncologic Surgery
Official title: The Effect of Chewing Gum and Hot Compresses on Postoperative Pain, Bowel Function, and Patient Comfort After Gynecologic Oncologic Surgery: a Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Gynecologic Nursing
Pain
Lead sponsor: Istanbul Medeniyet University
Sponsor class: OTHER
Collaborators: name: Istanbul University
name: Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
First posted: 2024-01-09
Enrollment: 84
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: The passage discusses the recovery of gastrointestinal (GI) function after abdominal surgery and the potential impact on patient comfort. After surgery, small bowel activity typically returns to normal within a few hours, gastric activity within 24-48 hours, and colonic activity within 48-72 hours. However, the delayed mobility of the GI system postoperatively can lead to issues such as abdominal bloating, nausea, vomiting, and pain. These symptoms can negatively affect patient comfort, leading to increased post-operative pain, decreased mobility, reduced satisfaction, and a longer hospital stay. Therefore, interventions that expedite the normalization of bowel activity are crucial. Chewing is suggested to stimulate intestinal motility by activating the cephalovagal pathway, which influences neurogenic and hormonal factors regulating GI functions. Postoperative heat application aims to prevent hypothermia, enhance bodily functions, and potentially promote bowel motility by stimulating somatic nerves. The study explores the effects of gum chewing and hot application protocols on postoperative pain, bowel function, and patient comfort after gynecologic oncologic surgery. It aims to contribute valuable insights to the existing literature on postoperative outcomes.

Detailed description: After abdominal surgery, small bowel activity returns to normal within a few hours, gastric activity within 24-48 hours, and colonic activity within 48-72 hours. Due to the delayed mobility of the gastrointestinal (GI) system in the postoperative period, gas and secretions accumulated in the stomach and intestines cause abdominal bloating, nausea, vomiting, and pain, negatively impacting patient comfort. This can lead to increased post-operative pain, decreased post-operative mobility, decreased patient satisfaction and prolonged hospital stay. Therefore, procedures that shorten the time to normalization of bowel activity in the postoperative period are very important. Chewing stimulates intestinal motility in humans. The chewing mechanism is thought to work by stimulating the cephalovagal pathway. Stimulation of the cephalovagal pathway stimulates various neurogenic and hormonal factors that modulate the functions of the gastrointestinal tract. Problems related to decreased intestinal motility after minimally invasive surgery can cause postoperative side effects due to delayed recovery of GI function. The basic rationale of postoperative heat application is to prevent the development of hypothermia during and after surgery by regionally warming the patient's body, eliminating the slowing effect of hypothermia, and helping to activate bodily functions early. It has been suggested that heat application may reflexively promote bowel motility by stimulating somatic nerves via the supraspinal or spinal cord, and it has been demonstrated that stimulation of warm receptors in the skin with heat may reflexly inhibit sympathetic nerves and promote parasympathetic nerve activity in the bowel as a supraspinal and spinal reflex. There are few studies in the literature examining the effect of chewing gum and heat application on postoperative outcomes after gynecologic oncologic surgery. No study was found that compared the two applications. This study was designed to compare the effects of gum chewing and hot application protocols on postoperative pain, bowel function, and patient comfort after gynecologic oncologic surgery. It is believed that this study will make an important contribution to the literature.

Eligibility criteria: Inclusion Criteria:

* 18 years of age or older
* To undergo elective minimally invasive gynecologic surgery
* No cognitive, affective and mental problems that would prevent gum chewing and hot application
* Does not have any chronic disease
* No previous abdominal surgery
* Turkish speaking and
* Women who volunteer to participate in the study will be included.

Exclusion Criteria:

* Who wants to leave the work for any reason
* History of ileostomy and colostomy
* He was taken to intensive care after the surgery and
* Women with postoperative complications (bleeding, infection, etc.) will be excluded from the study.

Primary outcomes:
measure: Visual Analog Scale
timeFrame: 8 months
measure: General Comfort Scale
timeFrame: 8 months
Secondary outcomes:
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Dr. Abdurrahman Yalcin Training and Research Hospital
Study officials:
affiliation: Dr. Abdurrahman Yalcin Training and Research Hospital
name: Merve Beke, MSc
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Schneider S, Armbrust R, Spies C, du Bois A, Sehouli J. Prehabilitation programs and ERAS protocols in gynecological oncology: a comprehensive review. Arch Gynecol Obstet. 2020 Feb;301(2):315-326. doi: 10.1007/s00404-019-05321-7. Epub 2019 Oct 15.
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