Effectiveness of lactulose syrup after cardiac surgery

Dutch cardiac surgery centers lack consistency in management with respect to the prevention of postoperative constipation. Although not based on any evidence, the administration of lactulose syrup is widely used. Because it often causes intestinal discomfort such as abdominal pain, bowel cramps, and feelings of distention, a study was performed in postoperative cardiac surgery patients who were given either standard care (routine administration of lactulose syrup twice daily) or laxative on indication. Postoperative constipation appeared equally frequent in both groups, and patients who received lactulose had more symptoms of intestinal discomfort. Based on these findings, it is safe to abolish the routine management of postoperative laxatives on a cardiac surgery ward.