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Health Condition(s) or Problem
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Constipation; Abdominal Pain; Nausea; Vomiting
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Lay Summary
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Constipation following elective Caesarean sections (CS) is a common problem experienced by
up to 50% of patients (1). The causes for this are multifactorial and include manipulation
of the bowel during surgery, immobilisation and opiate based anaesthetic and analgesic
techniques. To try to alleviate the problem of postoperative constipation, some
anaesthetists prescribe postoperative lactulose in addition to postoperative analgesia,
although no data exists that shows whether this has any beneficial effect on postoperative
constipation.
1. Short term morbidity associated with Caesarean delivery. Hillan EM. Birth. 19 (4):
190-4).
(from ClinicalTrials.gov)
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Who can enter the trial
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Inclusion Criteria:
- All patients aged 16 years or older able to give informed consent undergoing their
first or second elective CS
Exclusion Criteria:
- Unable to give informed consent
- A basic level of literacy sufficient to complete postoperative form.
- History of constipation
- Regular opiate use
- Previous bowel surgery or bowel adhesions
- Lactose intolerant
- Diabetic
- Any patient unable to have spinal Anaesthesia
- Allergies/intolerant to bupivacaine, diamorphine, diclofenac, cocodamol, lactulose
- Patients receiving injury to bowel intraoperatively
- Patients receiving additional opiates perioperatively
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Who cannot enter the trial
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Inclusion Criteria:
- All patients aged 16 years or older able to give informed consent undergoing their
first or second elective CS
Exclusion Criteria:
- Unable to give informed consent
- A basic level of literacy sufficient to complete postoperative form.
- History of constipation
- Regular opiate use
- Previous bowel surgery or bowel adhesions
- Lactose intolerant
- Diabetic
- Any patient unable to have spinal Anaesthesia
- Allergies/intolerant to bupivacaine, diamorphine, diclofenac, cocodamol, lactulose
- Patients receiving injury to bowel intraoperatively
- Patients receiving additional opiates perioperatively
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What will happen
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Drug; Lactulose; Lactulose liquid. 15mls twice daily; Lactulose group; Lactugal, Rectulose, Lactulose (non proprietry)
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Primary aim
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Time in hours to passage of first stool post Caesarean Section.
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Secondary Aim
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Frequency of abdominal pain between lactulose and non-lactulose groups.; First 5 days post Caesarean section.; No; Frequency of abdominal pain between lactulose and non-lactulose groups post Caesarean Section.; Frequency of nausea and vomiting between lactulose and non-lactulose groups; First 5 days post-Caesarean; No; Frequency of nausea and vomiting between lactulose and non-lactulose groups post Caesarean Section.
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Participant Information Sheet
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Sorry, not currently available
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Website
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Sorry, not currently available
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Recruitment Status
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Not Recruiting
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Nation
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Scotland
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Location
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Edinburgh
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