Pulmonary function in the early postoperative period

Abstract

To the author's knowledge, an intensive investigation of pulmonary function during the first 2 postoperative days has not previously been reported. Consequently, in this study the effect of regional surgery on respiratory function, monitored every 4 h during the first 2 postoperative days, was analyzed. Hypoxaemia was a constant finding in all patients undergoing general anaesthesia. The degree and duration of hypoxaemia and spirometry changes were related to the site of surgical incision. Clinical signs of atelectasis were commonly observed during the first postoperative day and occurred after the change in PO2 and spirometry. Atelectasis was more common in patients having upper abdominal surgery. The current investigation reveals that the earliest postoperative change indicative of atelectasis is the fall in PO2; that auscultatory changes do not always occur in the presence of postoperative hypoxaemia; that auscultatory signs are not indicative of the extent of the PO2 fall; and that radiology represents a crude method of assessing postoperative atelectasis.

Postoperative hypoxaemia and oxygen therapy

“…Each patient completed a questionnaire based on the respiratory questionnaire of the Medical Research Council (1962) and relevant intra-operative and postoperative factors were noted. The Po, was measured using arterialized capillary blood, which accurately reflects the arterial Po8 (Parfrey et al, 1977). The arterialized capillary blood was collected from the earlobe following local vasodilatation.…”

“…In a companion paper (Parfrey et al, 1977) we have investigated the pulmonary changes in the early postoperative period following regional surgery and significant decreases in Po, were observed in certain patients. The efficiency and predictability of oxygen therapy in the correction of hypoxaemia following upper abdominal surgery have been discussed by Drummond (1975), who confirmed that oxygen desaturation was relieved by breathing an oxygenenriched mixture, but desaturation developed again when the oxygen was withdrawn.…”

The Effect of Scoliosis Surgery on Lung Function in the Immediate Postoperative Period

“…[1][2][3][4][5][6] Pulmonary function testing (PFT) can provide objective, quantitative information on the type, severity, and functional impairment caused by a respiratory disorder. [7][8][9][10][11] Thoracic surgery decreases lung volumes, expiratory flow rates, and oxygenation after surgery as a result of the surgery itself, anesthesia, pain, and immobilization. 1,[11][12][13] In adult studies, thoracic and upper abdominal surgery may reduce lung volumes and flow rates 50% to 75% from their preoperative baseline values.…”

Hypoxaemia after left thoracotomy for benign oesophageal disease.

“…The cause of the hypoxaemia appears to be a combination of factors rather than any single mechanism.3 One factor which has been shown to affect the severity of hypoxaemia is the site of operation.4 5 In this report, upper abdominal incisions are associated with more profound hypoxaemia than incisions in the lower abdomen. Though there have been reports of hypoxaemia after pulmonary resection,' 6 7 there appear to be no published data regarding arterial oxygen levels after thoracotomy for non-cardiopulmonary disease.…”