Nonventilatory strategies to prevent postoperative pulmonary complications

Abstract

Nonventilatory strategies can play an important role in reducing PPCs and improving clinical outcome after noncardiac surgery, especially in high-risk patients.

Postoperative respiratory failure

“…During emergence from anesthesia, applying recruitment maneuvers and 40% oxygen concentration has been shown to improve oxygenation in comparison to administering 100% oxygen due to the development of readsorption atelectasis [48]. [52], avoiding transfusion, and using appropriately chosen and accurately dosed anesthetics [52] and neuromuscular blocking agents [20 && ].…”

“…(4) Surgical approach: measures for reducing the aggressiveness of procedures have been shown to reduce the risk of PRF [52]. (5) Postoperative strategies: a multimodal approach includes effective analgesia [52,53], physiotherapy [54 & ], and early treatment of postoperative hypoxemia [38,55] as the pillars of PRF prevention.…”

A Clinical Experimental Model to Evaluate Analgesic Effect of Remote Ischemic Preconditioning in Acute Postoperative Pain

“…The laparoscopic cholecystectomy is considered the gold standard for the surgical treatment of gallstones and is replacing the conventional technique in most services [ 25 ]. However, in Brazil, there are large disparities in income distribution between regions and the health system underfunding meaning that, in many services, the only option remains the conventional technique with transverse subcostal incision resulting in significant postoperative pain with considerable increase in morbidity due to reduced lung expansion and cough with pain [ 26 – 28 ]. In these cases, the use of neuraxial block technique results in better pain control postoperatively when compared to general anesthesia alone [ 29 – 32 ]; however despite this evidence many patients receiving spinal block as anesthetic technique remain in pain postoperatively and are more susceptible to the risk of postoperative chronic pain [ 33 , 34 ].…”