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Objective The aim of this study was to investigate if mobilization out of bed, within 2 hours after abdominal surgery, improved participants´ respiratory function and whether breathing exercises had an additional positive effect. Methods Participants were 214 consecutively recruited patients who underwent elective open or robot-assisted laparoscopic gynecological, urological, or endocrinological abdominal surgery with an anesthetic duration of >2 hours. They were recruited to a randomized controlled trial. Immediately after surgery, patients were randomly assigned to 1 of 3 groups: mobilization (to sit in a chair) and standardized breathing exercises (n = 73), mobilization (to sit in a chair) only (n = 76), or control (n = 65). The interventions started within 2 hours after arrival at the postoperative recovery unit and continued for a maximum of 6 hours. The primary outcomes were differences in peripheral oxygenation (oxygen saturation [Spo2], as a percentage) and arterial oxygenation (arterial oxygen pressure [Pao2], in kilopascals) between the groups. Secondary outcomes were arterial carbon dioxide pressure, spirometry, respiratory insufficiency, pneumonia, and length of stay. Results Based on intention-to-treat analysis (n = 214), patients who received mobilization and breathing exercises had significantly improved Spo2 (mean difference [MD] = 2.5%; 95% CI = 0.4 to 4.6) and Pao2 (MD = 1.40 kPa; 95% CI = 0.64 to 2.17) compared to the controls. For mobilization only, there was an increase in Pao2 (MD = 0.97 kPa; 95% CI = 0.20 to 1.74) compared to the controls. In the per-protocol analysis (n = 201), there were significant improvements in Spo2 and Pao2 for both groups receiving mobilization compared to the controls. Secondary outcome measures were not different between groups. Conclusions Mobilization out of bed, with or without breathing exercises, within 2 hours after elective abdominal surgery improved Spo2 and Pao2. Impact The respiratory effect of mobilization (out of bed) immediately after surgery has not been thoroughly evaluated in the literature. This study shows that mobilization out of bed following elective abdominal surgery can improve Spo2 and Pao2. Lay summary Mobilization within 2 hours after elective abdominal surgery, with or without breathing exercises, can improve patients’ respiratory function.

Objective Early mobilization is advocated for patients going through abdominal surgery; however, little is known about the patient experience of being mobilized immediately after surgery. The purpose of this study was to explore patient experiences of mobilization immediately after elective abdominal cancer surgery. Methods This interview study used qualitative content analysis. With the use of purposeful sampling, a total of 23 participants who had been mobilized immediately after abdominal surgery were recruited at a university hospital in Stockholm, Sweden. Individual face-to-face interviews were conducted within 1 to 4 days after surgery and took place at the surgical ward where the participants were treated. A semistructured guide was used. All interviews were audio recorded and transcribed verbatim. Results The content analysis revealed 3 categories that emerged into 1 overarching theme: “to do whatever it takes to get home earlier.” The participants experienced that mobilization out of bed had an impact on their physical and mental well-being. Motivation and the experiences of themselves and others were factors that affected patient attitudes toward early mobilization. Preparation and competent caregivers were emphasized as important factors that enabled the patient to feel safe and confident during mobilization. Conclusions Patients experienced mobilization as an important part of the care that had an impact on recovery and well-being, physically as well as mentally, both immediately and over time. Impact As the first study to investigate patient experiences of mobilization immediately after abdominal surgery, this information can be used to support the development of early mobilization protocols in hospital settings.