Comparison of the different dosages of rectal misoprostol on intestinal motility and pain score in high risk cesarean delivery

Abstract

Objective: To prospectively compare the efficacy of different dosages of rectal misoprostol on pain and intestinal motility in postoperative high risk cesarean delivery. Material and Methods: Consecutive 160 pregnant women with two or more previous cesarean sections who underwent cesarean delivery were randomly grouped to receive no drug (n= 40), 200 μg misoprostol (n= 40), 400 μg misoprostol (n= 40) or 600 μg misoprostol (n= 40) rectally before leaving the operating room. Primary outcomes were the time interval between surgery and first bowel movements and first flatus passage. Secondary outcome was the women's satisfaction measured with a visual analogue scale. Patient demographic characteristics, pre- and postoperative findings, pain scores on visual analog scale and adverse effects of the drug were assessed in all groups. Results: Time to first bowel movement and the first flatus passage were significantly shorter in the group given 600 μg rectal misoprostol than the others (p<0.001). There were no significant differences in postoperative pain scores on visual analogue scale and postoerative additional analgesic need among the groups (p= 0.270 and p= 0.906, respectively). The side effects of fever and shivering were found more frequent in the 600 μg misoprostol group, but the difference among the groups did not reach a statistical significance (p<0.01). Conclusion: Single dose rectal misopros-tol appears to be effective in recovery of gas troin testinal function after high risk cesareandelivery. © 2010 by Türkiye Klinikleri.