title: The effect of analgesics and physical therapy on respiratory function after open and laparoscopic cholecystectomy.
abstract: In this study we present prospective clinical trial included 100 patients. One half of the patients underwent open cholecystectomy, whereas laparoscopic cholecystectomy was performed in the other half Spirometric parameters, arterial blood gases, acid-base balance, were determined preoperatively, and then at 6 h, 24 h, 72 h and 144 h postoperatively. The impact of physical therapy on the respiratory parameter patterns, VAS-pain score and use of tramadol were studied after cholecystectomy. Significantly lower VAS-pain score and less tramadol use, higher values and faster recovery of ventilation parameters and PaO2 were recorded after laparoscopic cholecystectomy than after open cholecystectomy (p = 0.001 for both). Physical therapy resulted in a significant improvement in the values of respiratory parameters in the open cholecystectomy group within a short time (30 min) after therapy was performed. Physical therapy failed to produce any improvement of respiratory parameters in laparoscopic cholecystectomy, whereas in open cholecystectomy group who had a favorable although transient effect, strictly limited to the short time from its application. (p = 0.005). The patients operated on by open cholecystectomy had statistically significantly more pronounced disturbances including hypoxia, hypocapnia and hyperventilation when compared to the group submitted to laparoscopic cholecystectomy. It is recommended that physical therapy be more frequently performed during the postoperative period in patients submitted to open cholecystectomy.
authors.affiliation: Department of Surgery, University Hospital Split, School of Medicine, University of Split, Split, Croatia.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Mimica
authors.forename: Zenon
authors.initials: Z
authors.lastname: Pogorelić
authors.forename: Darko
authors.initials: D
authors.lastname: Srsen
authors.forename: Zdravko
authors.initials: Z
authors.lastname: Perko
authors.forename: Radoslav
authors.initials: R
authors.lastname: Stipić
authors.forename: Domagoj
authors.initials: D
authors.lastname: Dujmović
authors.forename: Jadranka
authors.initials: J
authors.lastname: Tocilj
authors.forename: Darko
authors.initials: D
authors.lastname: Ujević
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D005541:Forced Expiratory Volume; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain; D026741:Physical Therapy Modalities; D012119:Respiration / Q000187:drug effects*; D014797:Vital Capacity
chemical_list: D000700:Analgesics