Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial.
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.
Manzano
Roberta Munhoz
RM
Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil. roberta_m_m@hotmail.com
Carvalho
Celso Ricardo Fernandes de
CR
Saraiva-Romanholo
Beatriz Mangueira
BM
Vieira
Joaquim Edson
JE
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