Evaluation of Pulmonary Function Tests in Patients Undergoing Laparotomy
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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.
Keywords
- Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A et al. Standardization of spirometry. Eur Respir J 2005;26:319-38
- Beecher HK. Effect of laparotomy on lung volume: Demonstration of a new type of pulmonary collapse. J Clin Invest 1933;651:12.
- Collins CD, Darket MD, knowelden J. Chest complications after upper abdominal surgery: Their anticipation and prevention. Brit Med J 1968; 1: 401-06.
- Rehder K, Sessler AD, Marsh HM. General anesthesia and the lung. Am Rev Respir Dis 1975; 112:541-63.
- Marsh HM, Rehder K, Sessler AD, Fowler WS. Effects of mechanical ventilation, muscle paralysis and posture on ventilation-perfusion relationships in anesthetized man. Anesthesiology 1973; 38(1): 59-67.
- Russel WJ. Position of patient and respiratory function in immediate postoperative period.BMJ 1981;283:1079-80
- Simonneau G, Vivien V, Saltine R. Diaphragmatic dysfunction induced by upper abdominal surgery: role of postoperative pain. Am Rev Respir Dis 1983; 128:899
- Rehder K. Anesthesia and the respiratory system. Can Anesth Soc J 1979; 26(6):451-62.
- Brook lord. Abdominal operations.1969.5th ed. New York. p 484-91
- Guyton and Hall. Textbook of Medical Physiology. 11th ed. Elsevier Pvt. Ld.;2006: p 471-80.
- Keele C, Neil E, Joels N. Samsung Wrights Applied Physiology. 13th ed. Oxford University Press;2000 p 584
- Ford GT, Whitelaw WA, Rosenal TW, Cruse PJ, Guenter CA. Diaphragm function after upper abdominal surgery in humans. Am Rev Resp Dis 1983; 127: 431-36.
- Celli BR, Rodriguez KS, Snider GL. A controlled trial of intermittent positive pressure breathing, incentive spirometry, and deep breathing exercises in preventing pulmonary complications after abdominal surgery. Am Rev Resp Dis 1984; 130: 12-15.
- Ford GT, Rosenal TW, Clergue F. Respiratory physiology in upper abdominal surgery. Clin Chest Med 1993;14:237–52.
- Watters JM, Clancey SM, Moulton SB. Impaired recovery of strength in older patients after major abdominal surgery. Ann Surg 1993; 218:380–90.
- Putensen-Himmer G, Putensen C, Lammer H. Comparison of postoperative respiratory function after laparoscopy or open laparotomy for cholecystectomy. Anesthesiology 1992; 77:675–80.
- Siafakas NM, Stoubou A, Stathopoulou M. Effect of aminophylline on respiratory muscle strength after upper abdominal surgery: a double blind study. Thorax 1993; 48:693–7.
- Mitchell C, Garrahy P, Peake P. Postoperative respiratory morbidity: identification and risk factors. Aust N Z J Surg 1982; 52:203–9.
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