Are postoperative activity restrictions evidence-based?
BACKGROUND
Many surgeons restrict activities postoperatively. Intra-abdominal pressure during some activities is known; however, many everyday activities have not been studied. Our aim was to compare the intra-abdominal pressures created during unavoidable physical activities with activities that commonly are restricted after surgery.


METHODS
Nine healthy subjects (2 men, 7 women; age, 28 +/- 7 y) performed 5 repetitions of various activities while their intravesicular pressures was measured.


RESULTS
The resting intravesicular pressure was 17 +/- 5 mm Hg, increasing to a maximum of 112 +/- 35 mm Hg during forceful coughing. The intravesicular pressure increase was greatest with forceful coughing, followed by the Valsalva maneuver.


CONCLUSIONS
The results suggest that the greatest increase in intra-abdominal pressure occurs during some unavoidable activities. Based on this study, postoperative restrictions may be unnecessary. Further experience based on a larger study is needed to answer this important clinical question.
Guttormson
Robert
R
Department of Surgery, Synergy Medical Education Alliance, 1000 Houghton Ave., Saginaw, MI 48602, USA. rguttormson@synergymedical.org
Tschirhart
James
J
Boysen
Dennis
D
Martinson
Kurt
K
D034841:Abdominal Cavity / Q000502:physiology; D000328:Adult; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011182:Postoperative Care; D011312:Pressure; D001743:Urinary Bladder / Q000502:physiology*