Arch Hellen Med, 32(6), November-December 2015, 724-731
The effect of respiratory physiotherapy on pain and pulmonary complications in major upper abdominal surgery
S. Syropoulos, A. Kalogeropoulos, G. Maniatis, Z. Iliodromiti
OBJECTIVE To investigate the effectiveness of the active cycle of breathing techniques (ACBT) applied to reduce pain and to prevent pulmonary complications in patients undergoing major surgery in the upper abdomen.
METHOD Twenty patients aged 51–82 years who underwent upper abdominal surgery were randomly divided into an experimental (n=10) and a control group (n=10). All patients underwent the usual postoperative respiratory physiotherapy for 7 days. The experimental group was also submitted to ACBT. Factors observed daily in both groups were: Ρain at rest, pain during coughing, body temperature, white blood cell count (WBC) and oxygen saturation (SPO2).
RESULTS The changes in the parameters in relation to the time showed no statistically significant differences between the two groups (p>0.05). Pain at rest and during coughing began to decrease from the first postoperative day in both groups. A continuous reduction in body temperature was observed from the first day in the experimental group compared with the control group, but the difference was not statistically significant. The WBC decreased during the first 5 days in both groups but increased on the 7th day in the control group; this increase was not statistically significant. Finally, the SPO2 was higher in the experimental group, but statistically significant difference in SPO2 between the two groups was found only during the 6th day (p=0.012).
CONCLUSIONS ACBT appears to be associated with reduction of pain during coughing from the 5th postoperative day, of body temperature on the 4th postoperative day and the WBC on the 5th postoperative day, but not to a significant degree. ACBT was associated with significant increases in the SPO2 from the 3rd postoperative day, but was no better at preventing pulmonary complications than the usual postoperative physiotherapy routine.
Key words: Atelectasis, Pain, Physiotherapy, Pneumonia, Upper abdominal surgery.