May 1991

A New Oral Lavage Solution vs Cathartics and Enema Method for Preoperative Colonic Cleansing

Author Affiliations

From the Colorectal Surgery Service, Department of General Surgery, Wilford Hall USAF Medical Center, Lackland Air Force Base, Tex (Dr Beck), and the Division of Gastroenterology, University of South Alabama, College of Medicine, Mobile (Dr DiPalma).

Arch Surg. 1991;126(5):552-555. doi:10.1001/archsurg.1991.01410290024003

• Sulfate free–electrolyte lavage solution is a new osmotically balanced electrolyte gut lavage solution for colon surgery that has been formulated for improved taste and reduced water and electrolyte changes. Sixty patients were prospectively randomized to receive a 1-day preparation with sulfate free–electrolyte lavage solution or a 3-day preparation using a clear liquid diet, cathartics, and enemas. The patient groups were similar in age, race, male-female ratio, and the types of colonic resections performed. Colonic cleansing was better with sulfate free–electrolyte lavage solution (100% vs 63% "good" to "excellent" cleansing). Patient tolerance evaluated by a questionnaire showed more overall discomfort with sulfate free–electrolyte lavage solution but no difference between the preparations in individual symptoms of fullness, cramping, nausea, or vomiting. One patient developed a low level of serum potassium after a cathartic and enema preparation, while there were no complications with sulfate free–electrolyte lavage solution. Patient taste questionnaires showed a slight preference for sulfate free–electrolyte lavage solution (53%) over a polyethylene glycol electrolyte lavage solution (47%). This study confirms that sulfate free–electrolyte lavage solution is a safe and effective method of preoperative colonic cleansing.

(Arch Surg. 1991;126:552-555)