Abstract
Background: Open abdominal and laparoscopic surgeries impair the respiratory function. Lung expansion techniques (LET) are widely used to recover pulmonary volumes on the postoperative period; however, the effect of each LET on thoracoabdominal mechanics after different types of surgical access remains unknown.
Objective: To compare the effects of LET on thoracoabdominal mechanics in patients underwent to open abdominal or laparoscopic surgeries.
Methods: 84 consecutive candidates for open abdominal and laparoscopic surgery were randomly assigned into 4 groups: CPAP (n=22), volume incentive spirometry (n=21); flow incentive spirometry (n=20) and deep breathing (n=21). Patients were assessed before and 3 days after surgery to quantify chest wall volume (optoelectronic plethysmography) and sternocleidomastoid, superior and inferior intercostal muscles activity (surface electromiography) during quiet breathing and performing LET. The LET (50 repetitions of the group technique) was performed 3 times per day during 3 consecutive days.Data were analyzed considering the different types of surgical access by using two-way (LET and surgical access) ANOVA.
Results: All groups were homogenous for age, gender, BMI and lung function. Open abdominal and laparoscopic surgeries similarly decreased chest wall volumes (41±16 vs. 38±16mL, p=0.97)and overall inspiratory muscle activity (0.9±0.7 vs. 1.4±0.8µV, p=0.75) on 3rd postoperative day. No difference on the thoracoabdominal mechanics was observed among all LET for both types of surgical access (p>0.05)
Conclusion: All studied LET have similar effect on thoracoabdominal mechanics, independent of the type of surgical access.
- Copyright ©ERS 2015
