Consequences of postoperative alterations in respiratory mechanics

Ali, Jameel; Weisel, Richard D.; Layug, A. B.; Kripke, Benjamin J.; Hechtman, Herbert B.

doi:10.1016/0002-9610(74)90176-7

Cited by 216 publications

(35 citation statements)

References 15 publications

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“…Also, the tidal volume increased by 23% in comparison to the placebo group, whereas the respiratory rate (RR) tended to decrease after the use of TENS, thus resulting in a slight improvement of the minute volume. These data corroborate those of other studies such as Ali et al 3 , which reported improved VC after the use of TENS; Stratton and Smith 26 , which also found improved forced vital capacity (FVC) after the use of TENS; and Cipriano 27 , which demonstrated the positive effects of TENS on pulmonary and musculosketal functions of patients in the postoperative period of cardiac surgery. Erdogan et al 13 conducted a controlled prospective randomized double-blind study evaluating the efficacy of TENS in thoracic surgery, and demonstrated beneficial effects of electrostimulation in their patients, so that they needed less opioid analgesics and their cough effort was increased during physical therapy.…”

Section: Discussionsupporting

confidence: 90%

“…The surgical wound pain restricts lung expansion to a certain extent, thus favoring respiratory complications. Pulmonary complications are the major causes of morbidity in the postoperative period of cardiac surgery, and can contribute to the reduction of respiratory muscle strength, lung volumes and capacity; atelectasis is one of the most common of them, affecting approximately 64% of patients undergoing surgery [3][4][5][6] .…”

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confidence: 99%

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Estimulação elétrica nervosa transcutânea de curta duração no pós-operatório de cirurgia cardíaca

Gregorini

Cipriano

Aquino

et al. 2010

Arq. Bras. Cardiol.

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Background: Respiratory muscle strength has been related to the postoperative outcome of cardiac surgeries. The main documented therapeutic purpose of transcutaneous electrical nerve stimulation (TENS) is the reduction of pain, which could bring secondary benefits to the respiratory muscles and, consequently, to lung capacities and volumes.Objectives: The objective of the present study was to evaluate the effectiveness of short-duration transcutaneous electrical nerve stimulation (TENS) in the reduction of pain and its possible influence on respiratory muscle strength and lung capacity and volumes of patients in the postoperative period of cardiac surgery.Methods: Twenty five patients with mean age of 59.9 ± 10.3 years, of whom 72% were men, and homogeneous as regards weight and height, were randomly assigned to two groups. One group received therapeutic TENS (n = 13) and the other, placebo TENS (n = 12), for four hours on the third postoperative day of cardiac surgery. Pain was analyzed by means of a visual analogue scale, and of respiratory muscle strength as measured by maximum respiratory pressures and lung capacity and volumes before and after application of TENS. Results

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

Estimulação elétrica nervosa transcutânea de curta duração no pós-operatório de cirurgia cardíaca

Gregorini

Cipriano

Aquino

et al. 2010

Arq. Bras. Cardiol.

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“…Por outro lado, a manutenção do VC, VM e FR no primeiro dia do pós-operatório, ou seja, nas primeiras 24 horas após a cirurgia, para as quais se tem relato da presença da disfunção diafragmática, acarretando na diminuição dos volumes pulmonares e capacidades pulmonares 23,25 , pode ser atribuído à realização da FRC pré-operatória ambulatorial.…”

Section: Resultsunclassified

Fisioterapia respiratória associada à pressão positiva nas vias aéreas na evolução pós-operatória da cirurgia bariátrica

et al. 2012

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RESUMO | Analisar volume corrente (VC), volume minuto (VM) e frequência respiratória (FR) de obesas mórbidas no pós-operatório de cirurgia bariátrica (CB), após a fisioterapia respiratória convencional (FRC) associada ou não à pressão positiva contí-nua nas vias aéreas (CPAP) no pré-operatório. Foram estudadas 36 mulheres, com idade de 40, 1±8, 41 anos, que seriam submetidas à CB por laparotomia e que realizaram FRC (exercícios respiratórios diafragmáticos, de inspirações profundas, fracionadas e associados a movimentos de membros superiores, 1 série de 10 repetições de cada exercício) por 30 dias antes da cirurgia. Após internação, 18 delas foram submetidas a 20 minutos de CPAP, 1 hora antes da indução anestésica e compuseram o grupo FRC+CPAP. As outras 18 não receberam o CPAP e compuseram o grupo FRC. Foram avaliados VM, VC e FR por meio do ventilômetro, no momento da internação e 24 horas após a realização da cirurgia. Constatou-se que as medidas de VC, VM e FR não apresentaram significância estatística quando comparados os resultados do pré e pós-operatório em ambos os grupos, bem como quando comparados os dois grupos entre si tanto no pré como no pós-operatório. Os resultados sugerem que a tanto a aplicação da FRC como a aplicação da FRC+CPAP no período pré-operatório contribui para a manutenção das variá-veis respiratórias no pós-operatório. A aplicação do CPAP antes da indução anestésica não promoveu benefícios adicionais no pós-operatório de CB no que se refere aos volumes pulmonares.Descritores | cirurgia bariátrica; pressão positiva contínua nas vias aéreas; medidas de volume pulmonar; fisioterapia.ABSTRACT | To assess the tidal volume (VT), minute volume (MV) and respiratory rate (RR) of morbidly obese women in postoperative bariatric surgery (BS), after the conventional respiratory physiotherapy (CRP) with or without preoperatively continuous positive airway pressure (CPAP). Thirty-six women, aged 40. 1±8. 41 years, that would be submitted to BS by laparotomy were studied. All of them underwent preoperative outpatient conventional respiratory physiotherapy (CRP) (diaphragmatic breathing exercises, deep breathing, fractionated breathing and breathing associated to movements of the upper limbs, a series of 10 repetitions of each exercise) by 30 days. Once admitted, 18 were subjected to 20 minutes of CPAP, an hour before induction of anesthesia and composed group CRP+CPAP. The other 18 did not receive CPAP and composed group CRP. VT, MV, and RR were performed through the ventilometer, at admission and 24 hours after surgery. It was found that measures of TV, VM and RR were not statistically significant when comparing pre and postoperative in both groups and as well as when the two groups were compared between them in both pre and postoperative. The results suggest that both the application and the implementation of FRC and FRC+CPAP in the preoperative period contribute to the maintenance of respiratory variables in the postoperative period. The use of CPAP before induction of anesthesia, did not provide...

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“…Thoracosurgical procedures can also cause arterial hypoxemia, atelectasis and pneumonia. 4 The general administration of opioids represents the traditional method of treating postoperative pain in thoracic surgery -that they are most effective when administered intravenously, preferably through a patient-controlled analgesia (PCA) pump. Due to ineffectiveness, non-steroidal antiinflammatory drugs (NSAIDs) used in monotherapy do not apply in thoracic surgery.…”

Section: Resultsmentioning

confidence: 99%

Paravertebral blockade using a catheter implanted under visual control during thoracosurgical procedure as an ideal expedient for treating postoperative pain

Kulesza¹,

Szynkarczuk²

2018

Pol. Ann. Med.

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Consequences of postoperative alterations in respiratory mechanics

Cited by 216 publications

References 15 publications

Estimulação elétrica nervosa transcutânea de curta duração no pós-operatório de cirurgia cardíaca

Estimulação elétrica nervosa transcutânea de curta duração no pós-operatório de cirurgia cardíaca

Fisioterapia respiratória associada à pressão positiva nas vias aéreas na evolução pós-operatória da cirurgia bariátrica

Paravertebral blockade using a catheter implanted under visual control during thoracosurgical procedure as an ideal expedient for treating postoperative pain

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