Comparisons and correlations of pain intensity and respiratory and peripheral muscle strength in the pre- and postoperative periods of cardiac surgery

Abstract

ObjectiveTo evaluate respiratory and peripheral muscle strength after cardiac surgery. Additionally, we compared the changes in these variables on the third and sixth postoperative days.MethodsForty-six patients were recruited, including 17 women and 29 men, with a mean age of 60.50 years (SD = 9.20). Myocardial revascularization surgery was performed in 36 patients, replacement of the aortic valve in 5 patients, and replacement of the mitral valve in 5 patients.ResultsA significant reduction in respiratory and peripheral muscle strength and a significant increase in pain intensity were observed on the third and sixth postoperative days (p < 0.05), except for the variable maximal inspiratory pressure; on the sixth postoperative day, maximal inspiratory pressure values were already similar to the preoperative and predicted values (p > 0.05). There was an association between peripheral muscle strength, specifically between maximal expiratory pressure preoperatively (rs = 0.383; p = 0.009), on the third postoperative day (rs = 0.468; p = 0.001) and on the sixth postoperative day (rs = 0.311; p = 0.037). The effect sizes were consistently moderate-to-large for respiratory muscle strength, the Medical Research Council scale and the visual analog scale, in particular between preoperative assessment and the sixth postoperative day.ConclusionThere is a decrease in respiratory and peripheral muscle strength after cardiac surgery. In addition, maximal expiratory pressure is the variable that is most associated with peripheral muscle strength. These variables, especially respiratory and peripheral muscle strength, should be considered by professionals working in the intensive care setting.

Effectiveness of Inspiratory Muscle Training on Respiratory Muscle Strength in Patients Undergoing Cardiac Surgeries: A Systematic Review With Meta-Analysis

“…De Menezes et al [ 20 ] reported that reduced RMS was associated with decreased functional capacity and an increased period of recovery of lung function, as it is directly related to peripheral muscle strength. Therefore, improvement in RMS can improve FVC and FEV 1 and thereby the 6-minute walking distance.…”

Orientações De Alta Hospitalar Para O Desempenho Do Autocuidado Após a Cirurgia Cardíaca: Revisão Integrativa

“…Está associada à piora da independência funcional e à recuperação cirúrgica retardada. Seu adequado manejo pode contribuir para reduzir o tempo de internação hospitalar e diminuir taxas de complicação no período pós-operatório (37)(38)(39)(40) .…”

Effect of Musical Hearing On Anxiety, Pain, and Cardiorespiratory Parameters in Cardiac Surgery: Study Protocol of a Randomized Clinical Trial

“…Studies have evaluated the correlation between preoperative anxiety and postoperative pain in several surgical procedures [5][6][7]. In the postoperative period of cardiac surgeries, which are complex and large procedures, pain has still been shown to be very frequent, as indicated by several studies [8][9][10][11][12][13]. It is evident that uncontrolled postoperative pain prevents functional recovery, decreases the patient's quality of life, becomes a risk factor for persistent postoperative pain, chronic pain and disability, in addition to evidencing a low quality of care [14].…”