Prophylactic Chest Physiotherapy in Major Abdominal Surgery among Elderly Patients

Abstract

Introduction: Chest physiotherapy has long been an established mode of treatment for pulmonary complications after major abdominal surgery. This study aimed to assess the effect of prophylactic chest physiotherapy on the frequency and severity of pulmonary complications following abdominal surgery. Material and Methods: A randomized controlled study of prophylactic chest physiotherapy was conducted among fifty post-operative patients (age > 60 years) who underwent elective open major abdominal surgery and were admitted in surgical ward of a tertiary care center. The patients were randomized into two groups: treatment group (n=25) and control group (n=25). The treatment group patients were given preoperative verbal information and informed consent was taken to undergo chest physiotherapy. In group A (n=15), patients performed incentive spirometry and in group B (n=10), patient performed breathing exercises with pursed lips, deep breathing and coughing hourly. In the control group (Group C, n=25), patients were not given any preoperative chest physiotherapy. Observations: The frequency of pulmonary complications was higher in group C (Atelectasis-12%, Basal pneumonia-28%, Pleural effusion-4%) in comparison to group A (Atelectasis-6.6%, Basal pneumonia-6.6%) and group B (Atelectasis-10%, Basal pneumonia-10%). The frequency of postoperative pulmonary complications after major abdominal surgery was less with spirometry (group A- 40%) compared to other physiotherapy (group B, 50%). Complications were maximum in patients without physiotherapy (group C- 72%). Conclusion: Prophylactic chest physiotherapy significantly reduces the frequency and severity of pulmonary complications following abdominal surgery.

Keywords

• major abdominal surgery
• post-operative complications
• chest physiotherapy