Evaluation of Pulmonary Function Tests in Patients Undergoing Laparotomy

Background: Postoperative pulmonary complications are the most common cause of postoperative mortality and morbidity. In this study we tried to identify patients at high risk of developing postoperative pulmonary complication.

Objectives:

1. To compare and evaluate preoperative and postoperative values of pulmonary function tests parameters.

2. To study the effect of gender difference, site of surgery and body mass index on postoperative pulmonary function parameters.

Methods: Pulmonary Function Parameters were recorded preoperatively one day prior to surgery and postoperatively on 5th day. PFTs were recorded using RMS Helios spirometer and all the tests were conducted according to ATS/ERS guidelines.

Parameters recorded : TV,ERV,IRV,IC,VC,MVV,FVC,FEV1,FEV1/FVC,PEFR,PIFR Statistical analysis were carried out by using t test

Results: We found statistically significant decrease in all the pulmonary function parameters in postoperative period except that of FEV1/FVC. When we did intergroup statistical analysis, we found more decrease in PFT parameters in Male patients, Patients undergoing Upper abdominal surgery and in Obese patients.

Conclusion: Thus after laparotomy there are Restrictive type of ventilatory changes due to pain, altered pattern of ventilation and diphragmatic weakness. Male patients, patients undergoing upper abdominal surgeries & obese patients are high risk patients for pulmonary complications. Since these postoperative pulmonary changes can be easily diagnosed by spirometer, all patients undergoing laparotomy should undergo preoperative and postoperative spirometry. Also prophylactic preoperative physiotherapy and postoperative deep breathing exercises, incentive spirometry and chest physiotherapy can be beneficial in patients of laparotomy.