title: Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial.
abstract: OBJECTIVE
  Abdominal surgical procedures increase pulmonary complication risks. The aim of this study was to evaluate the effectiveness of chest physiotherapy during the immediate postoperative period among patients undergoing elective upper abdominal surgery.
  
  
  METHODS
  This randomized clinical trial was performed in the post-anesthesia care unit of a public university hospital.
  
  
  METHODS
  Thirty-one adults were randomly assigned to control (n = 16) and chest physiotherapy (n = 15) groups. Spirometry, pulse oximetry and anamneses were performed preoperatively and on the second postoperative day. A visual pain scale was applied on the second postoperative day, before and after chest physiotherapy. The chest physiotherapy group received treatment at the post-anesthesia care unit, while the controls did not. Surgery duration, length of hospital stay and postoperative pulmonary complications were gathered from patients' medical records.
  
  
  RESULTS
  The control and chest physiotherapy groups presented decreased spirometry values after surgery but without any difference between them (forced vital capacity from 83.5 +/- 17.1% to 62.7 +/- 16.9% and from 95.7 +/- 18.9% to 79.0 +/- 26.9%, respectively). In contrast, the chest physiotherapy group presented improved oxygen-hemoglobin saturation after chest physiotherapy during the immediate postoperative period (p < 0.03) that did not last until the second postoperative day. The medical record data were similar between groups.
  
  
  CONCLUSIONS
  Chest physiotherapy during the immediate postoperative period following upper abdominal surgery was effective for improving oxygen-hemoglobin saturation without increased abdominal pain. Breathing exercises could be adopted at post-anesthesia care units with benefits for patients.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil. roberta_m_m@hotmail.com
authors.forename: Roberta Munhoz
authors.initials: RM
authors.lastname: Manzano
authors.forename: Celso Ricardo Fernandes de
authors.initials: CR
authors.lastname: Carvalho
authors.forename: Beatriz Mangueira
authors.initials: BM
authors.lastname: Saraiva-Romanholo
authors.forename: Joaquim Edson
authors.initials: JE
authors.lastname: Vieira
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000762:Anesthesia Recovery Period; D001945:Breathing Exercises; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D026741:Physical Therapy Modalities / Q000592:standards*; D011182:Postoperative Care / Q000379:methods*; D011997:Recovery Room; D013147:Spirometry; D014797:Vital Capacity