Pain intensity and postoperative pulmonary complications among the elderly after abdominal surgery

Shea, Roberta A.; Brooks, Jo Ann; Dayhoff, Nancy E.; Keck, James

doi:10.1067/mhl.2002.129449

Cited by 79 publications

(42 citation statements)

References 22 publications

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“…19,46,[51][52][53] In the present study 34% of patients experienced postoperative pulmonary complications, which corresponds to the 36% reported for the total cohort of 600 patients who received AHA surgery following a multidisciplinary perioperative protocol. 7 Results of the present study showed that a higher proportion of patients who were nonindependently mobile on POD-7 experienced a pulmonary complication.…”

Section: Physical Performancementioning

confidence: 87%

“…Correspondingly, other studies found that patients reporting more pain or inadequate pain relief were less physically active after elective abdominal surgery. 45,51 Overall, fatigue and abdominal pain are the primary barriers to independent mobilization and may inhibit early ambulation, therefore a focus on these barriers and interventions aiming to deal with them, should be considered. Possible interventions are the use of intraoperative high-dose glucocorticoids, which attenuate inflammatory response and could reduce both fatigue and pain, as well as the use of psychotropic drugs that reduce fatigue.…”

Section: Barriers To Independent Mobilizationmentioning

confidence: 99%

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Physical performance following acute high-risk abdominal surgery: a prospective cohort study

Jønsson

Ingelsrud

Tengberg

et al. 2018

cjs

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Background: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). Methods:Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark. In the first postoperative week, all patients were evaluated daily with regards to physical performance, using the Cumulated Ambulation Score (CAS; 0-6 points) to assess basic mobility and the activPAL monitor to assess the 24-hour physical activity level. We recorded barriers to independent mobilization.Results: Fifty patients undergoing AHA surgery (mean age 61.4 ± 17.2 years) were included. Seven patients died within the first postoperative week, and 15 of 43 (35%) patients were still not independently mobilized (CAS < 6) on POD-7, which was associated with pulmonary complications developing (53% v. 14% in those with CAS = 6, p = 0.012). The patients lay or sat for a median of 23.4 hours daily during the first week after AHA surgery, and the main barriers to independent mobilization were fatigue and abdominal pain. Conclusion:Patients who receive AHA surgery have very limited physical performance in the first postoperative week. Barriers to independent mobilization are primarily fatigue and abdominal pain. Further studies investigating strategies for early mobilization and barriers to mobilization in the immediate postoperative period after AHA surgery are needed.Contexte : La chirurgie abdominale d'urgence à risque élevé est associée à un fort taux de mortalité, à des complications postopératoires multiples et à des hospitalisations prolongées. Il est donc nécessaire d'élaborer de nouvelles stratégies pour amélio-rer le rétablissement après ce type de chirurgie. La présente étude visait à décrire le fonctionnement physique et les obstacles aux déplacements autonomes chez les patients ayant subi une chirurgie de ce type (jours postopératoires 1 à 7).Méthodes : Nous avons recruté successivement les patients subissant une chirurgie abdominale d'urgence à risque élevé dans un hôpital universitaire du Danemark. Durant la première semaine postopératoire, tous les patients ont subi quotidiennement une évaluation visant à vérifier leur fonctionnement physique. Nous nous sommes servis du Cumulated Ambulation Score (CAS; de 0 à 6 points) pour évaluer la mobilité de base et du moniteur activPAL pour évaluer le niveau d'activé physique 24 heures par jour. Nous avons noté les obstacles aux déplacements autonomes.Résultats : Cinquante patients (âge moyen : 61,4 ans ± 17,2) ont été retenus. Sept sont décédés durant la première semaine postopératoire, et 15 des 43 patients restants (35 %) ne se déplaçaient pas encore de façon autonome (CAS < 6) le septième jour, une situation associée à l'apparition de c...

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Section: Physical Performancementioning

confidence: 87%

Section: Barriers To Independent Mobilizationmentioning

confidence: 99%

Physical performance following acute high-risk abdominal surgery: a prospective cohort study

Jønsson

Ingelsrud

Tengberg

et al. 2018

cjs

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“…One possibility is that by providing sufficient circumferential compression to reduce incision stresses during transfers and ambulation, the binder produced the lower pain scores reported by patients in the binder group; another is that the sensory input provided by the binder when in contact with the skin ''closed the gate'' on pain generated at the surgical site. 41 The importance of controlling movementassociated incision pain was also emphasized by Shea et al, 42 who reported that postoperative abdominal incision pain was greater during ambulation (range: 5.5-8.5 on a 0-10 rating scale) than at rest (range: 2.5-4.5). Similarly, Meisler 27 found that providing incision support with a ''sternum harness'' after cardiac surgery resulted in acute reductions in VAS pain scores during ambulation and coughing.…”

Section: Painmentioning

confidence: 97%

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Cheifetz¹,

Lucy²,

Overend³

et al. 2010

Physiotherapy Canada

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Purpose: Immobility and pain are modifiable risk factors for development of venous thromboembolism and pulmonary morbidity after major abdominal surgery (MAS). The purpose of this study was to investigate the effect of abdominal incision support with an elasticized abdominal binder on postoperative walk performance (mobility), perceived distress, pain, and pulmonary function in patients following MAS. Methods: Seventy-five patients scheduled to undergo MAS via laparotomy were randomized to experimental (binder) or control (no binder) groups. Sixty (33 male, 27 female; mean age 58 e 14.9 years) completed the study. Preoperative measurements of 6-minute walk test (6MWT) distance, perceived distress, pain, and pulmonary function were repeated 1, 3, and 5 days after surgery. Results: Surgery was associated with marked postoperative reductions (p < 0.001) in walk distance (P75-78%, day 3) and forced vital capacity (35%, all days) for both groups. Improved 6MWT distance by day 5 was greater (p < 0.05) for patients wearing a binder (80%) than for the control group (48%). Pain and symptom-associated distress remained unchanged following surgery with binder usage, increasing significantly (p < 0.05) only in the no binder group. Conclusion: Elasticized abdominal binders provide a non-invasive intervention for enhancing recovery of walk performance, controlling pain and distress, and improving patients' experience following MAS.Key Words: abdominal binder, abdominal surgery, Adapted Symptom Distress Scale, pain, 6-minute walk test RÉ SUMÉObjectif : L'immobilité et la douleur sont des facteurs de risque modifiables dans le dé veloppement de thrombo-embolie veineuse et de morbidité pulmonaire à la suite d'une intervention chirurgicale abdominale majeure. L'objectif de cette é tude é tait d'investiguer les effets d'un soutien de l'incision abdominale à l'aide d'une bande abdominale é lastique sur la marche (mobilité ) postopé ratoire, sur la douleur perç ue, la douleur et la fonction pulmonaire des patients à la suite d'une telle intervention. Mé thode : 75 sujets appelé s à subir une chirurgie abdominale majeure par laparotomie ont é té choisis de fac¸on alé atoire pour faire partie du groupe expé rimental (avec bande abdominale) et d'un groupe de contrô le (sans bande abdominale). De ce nombre, 60 (33 hommes et 27 femmes dont la moyenne d'â ge é tait de 58 e 14,9 ans) ont participé à l'é tude jusqu'à la fin. Les mesures pré opé ratoires comprenaient un test de marche de 6 minutes (TM6), une mesure du degré de douleur perç u, de la douleur et de la fonction pulmonaire; ces mesures ont aussi é té prises aux jours 1, 3 et 5 suivant l'intervention. Ré sultats : L'intervention chirurgicale a é té associé e à des diminutions postopé ratoires marqué es (p < 0.001) dans la distance de marche (P75-78 %, au jour 3) la capacité pulmonaire forcé e (35 %, tous les jours), et ce, pour les deux groupes. L'amé lioration du TM6 au jour 5 a toutefois é té plus importante (p < 0,05) chez les sujets portant une bande abdominale (80 %)...

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“…Ameliyat sonrası etkin olarak giderilmeyen ağrı, ameliyat ile başlayan stres yanıtının artmasına neden olabilir. Stres tepkisinin uzun sürmesi iyileşme sürecini etkileyerek komplikasyon gelişimine neden olur (Brown, Christo and Wu 2004;Shea, Brooks, Dayhoff and Keck 2002;Wang and Keck 2004). Ağrı, aynı zamanda NANDA (North AmericanNursingDiagnosisAssociation) hemşi-relik tanılarından birisi olup disiplinler arası işbirliği ile yönetilmesi gereken bir hasta gereksinimidir (Roper, Logan and Tierney, 1996).…”

Section: Gġrġġunclassified

Sezaryen Ameli̇yati Olan Lohusalarda Progresi̇f Gevşeme Egzersi̇zleri̇ni̇n Ağri Kontrolü Üzeri̇ne Etki̇si̇

Özlü¹,

Soydan²,

Çapık³

et al. 2016

HYD

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Pain intensity and postoperative pulmonary complications among the elderly after abdominal surgery

Cited by 79 publications

References 22 publications

Physical performance following acute high-risk abdominal surgery: a prospective cohort study

Physical performance following acute high-risk abdominal surgery: a prospective cohort study

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Sezaryen Ameli̇yati Olan Lohusalarda Progresi̇f Gevşeme Egzersi̇zleri̇ni̇n Ağri Kontrolü Üzeri̇ne Etki̇si̇

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