The aim of this study was to determine the action of an abdominal mechanical massage on postoperative pain and ileus after colectomy. Our hypothesis was that parietal abdominal stimulation could counteract, through common spinal sensitive pathways, with nociceptive visceral inputs involved in postoperative pain and ileus.
Methods: After preoperative randomization and informed consent, 25 patients (52 + 5 years) had active mechanical massage (AMM) in the entire abdominal wall using Cellu M50 device (LPG Valence - France), and 24 patients (60 + 6 years) had non AMM (placebo group) started the first day after colectomy. None of the patients had postoperative morbidity. Mechanical massage was performed by delivering an intermittent negative pressure on the abdominal wall resulting in aspiration. In the AMM group, the amplitude and the frequency of the rhythmic abdominal stimulation were those effective on muscular pain, when in placebo group uneffective parameters were used. Duration of each massage session was 15 min. Massage was performed daily until the 7th postoperative day. Visual analogic scale (VAS) pain score, doses of analgesics and delay between surgery and the time to first passage of flatus were assessed by an another observer than those performing massages and those performing randomization.
Results: Nor anaesthetic drugs (Diprivan, Fentanyl, Norcuron) used during surgery, nor their doses, nor the duration of the surgical procedure (AMM : 154 ± 46 min vs placebo : 143 ± 14, p > 0.05) were different between the AMM and placebo groups. After the 2th and the 3rd postoperative days respectively, VAS pain scale (p<0.001) and doses of analgesics (p<0.05) were significantly lower in the AMM group than in placebo group. Time to first passage of flatus was also significantly shorter in AMM group ( Day 1.8 ± 0.3 vs Day 3.6 ± 0.4 - p<0.01). No adverse effect was observed.
Conclusions: These results show that the mechanical massage of the abdomen wall decreases postoperative pain and reduced the duration of ileus after colectomy.
