PERIOPERATIVE BOWEL SOUND DYNAMICS AS A MARKER OF GASTROINTESTINAL RECOVERY IN PATIENTS UNDERGOING GENERAL ANESTHESIA: AN OBSERVATIONAL STUDY

Abstract

Introduction: Bowel sounds, also known as abdominal sounds, are produced by the movement of the intestines as food passes through them. These sounds are typically normal and indicate proper gastrointestinal function, assessed by healthcare providers using a stethoscope through a process known as auscultation. However, abnormal bowel sounds can suggest underlying issues, such as ileus, which is characterized by reduced intestinal activity and can lead to complications if not addressed. General anesthesia is known to inhibit gastrointestinal function, necessitating careful postoperative monitoring to ensure the timely resumption of bowel activity.

Materials and Methods: This was a prospective, randomized observational study conducted at Saveetha Medical College & Hospital between September 2023 and August 2024. The study included 50 patients aged 18 years and above, undergoing elective surgery under general anesthesia, and classified as ASA I & II. Patients undergoing abdominal or emergency surgeries were excluded. Bowel sounds were recorded at three intervals: preoperatively, immediately postoperatively, and 3 hours postoperatively using a stethoscope. The primary outcome measured was the change in bowel sounds post-anesthesia.

Results: The study participants had a mean age of 37.25 years (SD 10.76), with 44% males and 56% females. The mean BMI was 23 (SD 12), and the average duration of surgery was 2.85 hours (SD 1.42). Preoperatively, 10% of patients had a bowel sound frequency of less than 8, but this decreased to zero 6 hours postoperatively. The frequency of 11-14 increased from 56% preoperatively to 68% postoperatively, with a significant p-value of 0.036. Among patients with a BMI greater than 25 and surgery duration exceeding 3 hours, there was a significant increase in bowel sound frequencies at 3 and 6 hours postoperatively, with p-values of 0.024 and 0.001, respectively.

Conclusion: This study demonstrated that bowel sound monitoring is a vital component of postoperative care in patients undergoing general anesthesia. The gradual return of bowel sounds post-surgery, particularly in patients with higher BMI and longer surgeries, indicates the resumption of gastrointestinal motility and can guide the timing of nutritional intake and other recovery protocols. Further research is recommended to refine these monitoring techniques for enhanced patient outcomes.