Post-operative fatigue - a real phenomenon attributable to the metabolic effects of surgery on body nutritional stores.
Ambulatory monitoring of activity was undertaken in 97 patients before and at intervals following surgery employing a lightweight recorder and sensors to monitor posture and movement over 24h periods. A subjective assessment of fatigue, anthropometric measurements and clinical details were noted prior to each recording. Results were assessed using multiple regression analysis. Few patients exhibited any subjective feeling of fatigue. However, objective assessment did show a reduction in activity, several of the changes correlating with factors related to surgical stress and post-operative nutritional depletion. Reduction in time standing was related to both weight change at 2 weeks (p < 0.005) and duration of surgery (p < 0.05). Increase in time spent lying correlated with muscle loss at 2 weeks (p < 0.005). Number of steps walked was only influenced by weight change at 2 weeks (p < 0.05). Reduction in post-operative mobility may be related to the metabolic consequences of the surgery and its effects on depletion of nutritional stores. Manipulation of the response and aggressive nutritional support might well reduce post-operative fatigue.
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Department of Surgery, University of Newcastle Upon Tyne, Framlington Place, Newcastle Upon Tyne, UK.
Clague
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Johnston
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