Open Access
Subscription Access
Open Access
Subscription Access
Effect of Deep Breathing Exercises and Incentive Spirometry in the Prevention of Post Operative Pulmonary Complications in the Patients of Cancer Esophagus undergoing Esophagectomy
Subscribe/Renew Journal
The purpose of this study was 1) to evaluate the efficacy of deep breathing exercises over no chest physiotherapy 2) to evaluate the efficacy of incentive spirometry over no chest physiotherapy 3) to evaluate the efficacy of deep breathing exercises over incentive spirometry.
Inclusion criteria
Both sexes i.e. male&female were included in the study. Adults undergoing any type of esophagectomy for carcinoma of esophagus were also included because this population of adults represents with similar probable mechanisms for the development of pulmonary complications i.e. above the age of 18 years. Middle aged people& old people were also included in the study because they are more prone to develop post operative pulmonary complications after anesthesia.
Patients who gave their written consent for conducting this study on them. Patients who were not referred for physiotherapy even after esophagectomy were included in control group.
Only those patients who were assessed&examined preoperatively&for the initial 5 post operative days were included. Cooperative patients who followed the given instructions (such as the use of I.S.) properly.
Methods
Three groups of patients were made keeping 10 patients in each group. Group 1 patients were given deep breathing exercises manually, group 2 patients were asked to do incentive spirometry only& group 3 was control group. Deep breathing exercises were given in lying position with the head end of bed raised to 30-40 degrees. Incentive spirometry was given in sitting position with foot supported. The study was conducted in the post surgical unit of Rajiv Gandhi Cancer Institute&Research Center Sector 5 Rohini New Delhi -85 (India). Chest expansions at axilla, nipple&xiphisternum, Single breath count, Peak expiratory flow rate&oxygen saturation were the dependant variables.
Results
It was found that deep breathing exercise and Incentive spirometry are more effective than no chest physiotherapy. The results of the study further suggests that comparison of the two modalities i.e. Incentive spirometry&deep breathing exercises revealed no stastically significant difference among them.
Conclusion
The results of the study concluded that deep breathing exercises& incentive spiromety should be recommended as treatment modalities in the prevention of post operative pulmonary complications in the patients of carcinoma esophagus undergoing esophagectomy.More studies with greater sample population are required for the generalization of the results.
- Williams Marie T et al. Chest physiotherapy and cystic fibrosis. Chest 106: 1872-1882; 1994.
- Crowe M. Jean, Bradley Christine et al. Effectiveness of incentive spirometry with physical therapy for patients after coronary artery bypass surgery. Physical therapy. 77: 260-268; 1997.
- Stratton Steven A, Smith Martha et al. Effect of transcutaneous electrical nerve stimulator on forced vital capacity. Physical Therapy. 60: 45-47; 1980.
- Dull Jan, Dull L. William et al. Is maximal inspiratory breathing exercise or incentive spirometry better than early mobilization after cardiopulmonary bypass. Physical therapy. 63: 655-659; 1983.
- Dureuil Bertrand, Viires Naima, Cantineau JP, Aubier Michel & Desmonts JM et al. Diaphragmatic contractility after upper abdominal surgery. American Jr. 1773-1780; 1986.
- Bartlett RH, Gazzaniga AB, Geraghty T.R. et al. Respiratory maneuvers to prevent postoperative pulmonary complications. JAMA. 224: 1017-1021; 1973.
- Mcconnell D.H, Maloney DJ, BuckBerg DG. Postoperative intermittent positive pressure breathing treatment physiologic considerations. J Thorac. Cardio Vascular surgery 68: 944-52; 1974.]
- Bartlett RH, Hauson EL, Moore FD. Physiology of yawning and its application to postoperative care. Surg forum 21: 222-275; 1970.
- Sagher F. A., Roushdy M.A., Hweta A.M. Peak expiratory flow rate nomogram in Libian school childs. Chest. 5: 1-3; 1999.
- Chattergee C. C. Textbook of human physiology. 10th Edition 1991. Sehgal publications chapter 3. Physiology of oxygen saturation. 389-390.
- Kisner Carolyn & Colby Lynn Allen. Textbook of therapeutic exercise, foundation & techniques. 3rd Edition 1996. Jaypee Brothers medical publications New Delhi. Chest physical therapy chapter 19. 665-680.
- Bayer R, Wilkinson D.Directly observed therapy for Tuberculosis. History of an idea. Lancet 345:1545-1548;1995
- Baxter W.D., Williams RHP and Levine R.S. The evaluation of the incentive spirometer in the prevention of postoperative pulmonary complications. British Jr. surgery 98: 389-392; 1971.
- Cordell A. Robert & Ellison G. Robert. Textbook of complication of intra thoracic surgery. 1st Edition 1979. Little brown & company Boston. Joseph W. Rubin’s Chylothorax complicating intrathoracic operations. 359-361
- Coon W.W. and Coller F.A. clinicopathalogic correlation in thromboembolism. Surgery Gynecol. Obstet. 109: 259; 1959.
- Dohi Suji, Gold martin et al. Comparison of two methods of postoperative respiratory care. Chest. 73: 592-601; 1978.
- Ford G T, Guenter C A. et al. Towards Prevention of Postoperative Pulmonary Complications A M. Rev. Respir Dis 130: 4-5; 1984.
- Davidson Stanley, Crompton G.K, Haslett’s Textbook of principals & practice of medicine. Disease of respiratory system. Ed; 17: 326-328; 1995.
- Iverson LIG, Ecker RR, FOX HE, May IA. A comparative study of intermittent positive pressure breathing, the incentive spirometer and blow bottles: the prevention of atelectasis following cardiac surgery. Ann Thoracic surgery 25: 197-200; 1978.
- Jung Ralph, James Wight, Leonard Rosoff, Nurser Richard et al. Comparision of three methods of respiratory care following upper abdominal surgery. Chest. 78: 31-35; 1980.
Abstract Views: 1673
PDF Views: 0