Klinik Araştırma
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Sigara içen hastalarda ameliyat sonrası üç top solunum egzersiz uygulamasının solunum fonksiyon testleri üzerine etkisi

Yıl 2023, Cilt: 3 Sayı: 1, 25 - 31, 27.04.2023
https://doi.org/10.58961/hmj.1229707

Öz

Amaç: Anestezi altında cerrahi girişimler sonrasında ortaya çıkan pulmoner komplikasyonları azaltmak için insentif spirometri kullanılmaktadır. Bu çalışmada, sigara içen ve genel anestezi altında ekstremite cerrahisi uygulanan hastalarda post operatif insentif spirometri uygulamasının solunum fonksiyon testleri üzerine etkisini araştırmayı amaçladık.
Çalışma Planı: 3. Basamak bir hastanede extremite operasyonu uygulanan, 18-61 yaş arası, ASA I-II fizyolojik skoru olan80 hasta çalışmaya dahil edildi. Hastalar her grupta 40 hasta olarak en az 5 yıl/günde 10-20 adet sigara içen ve sigara içmeyen olarak 2 gruba ayrıldıktan sonra her grup insentifspirometri (üç top solunum eksersizi) kullanıp kullanmayacağına göre randomize edildi. Grup K (n=20): Sigara içmeyen ve insentifspirometri kullanmayan, Grup T (n=20): Sigara içmeyen ve insentifspirometri kullanan, Grup S (n=20): En az 5 yıl/günde 10-20 adet sigara içen ve insentifspirometri kullanmayan, Grup ST (n=20): En az 5 yıl/günde 10-20 adet sigara içen ve insentifspirometri kullanan.
Bulgular: Çalışmaya katılan hastaların demografik verileri gruplar arasında benzerdi. Preoperatif ve postoperatif FVC ve FEV1 değerleri bakımından gruplar karşılaştırıldıklarında Grup K ve Grup S’deki postoperatif FVC değerleri preoperatif değerlere göre anlamlı derecede düşük bulundu (sırasıyla p=0,001, p=0,002).Gruplar içi karşılaştırmalarda Grup K, Grup S ve Grup ST’dekipostoperatif PEF değerleri preoperatif değerlere göre anlamlı derecede düşük bulundu (sırasıyla p=0,024, p=0,024, p=0,001). Gruplar içi karşılaştırıldıklarında Grup K ve Grup S’deki postoperatif VC değerleri preoperatif değerlerine göre anlamlı derecede düşük bulundu (sırasıyla p=0,037, p=0,012). Gruplar kendi içlerinde preoperatif ve postoperatif FEV1/FVC değerleri bakımından istatistiksel olarak karşılaştırıldıklarında anlamlı bir fark bulunmadı (p>0,05).
Sonuç: Genelanestezi alan sigara içen hastalarda postoperatifkötüleşen solunum fonsiyon testi değerlerinininsentifspirometre kullanımı ile düzeldiği saptandı. Bu nedenle genel anestezi altında uygulananekstremite operasyonlarında postoperatif dönemde insentifspirometri kullanımının, postoperatif solunum komplikasyonlarını önlemede faydalı olacağı düşünülmektedir.

Kaynakça

  • 1. Restrepo RD, Wettstein R, Wittnebel L, Tracy M; AmericanAssociationforRespiratoryCare. AARC ClinicalPracticeGuideline. Incentivespirometry. RespirCare 2011;56(10):1600-1604.
  • 2. Carvalho CR, Paisani DM, Lunardi AC. Incentivespirometry in majör surgeries: a systematicreview. RevBrasFisioter 2011;15(5):343-350.
  • 3. Cassidy MR, Rosenkranz P, McCabe K, Rosen JE, McAneny D. I COUGH: Reducingpostoperativepulmonarycomplicationswith a multidisciplinarypatientcare program. JAMA Surg 2013;148(8):740-745.
  • 4. Paiva DN, Assmann LB, Bordin DF, et al. Inspiratorymuscletrainingwiththresholdorincentivespirometry: Which is themosteffective? RevistaPortuguesa de Pneumologia (English Edition). 2015;21:76–81. 5. Peirovifar A. Effects of passiveandactivesmoking on induction of anesthesia, MedicalFacultyJournal of GuilanUniversity of MedicalSciences 2002;1:42.
  • 6. Rodrigo C. Theeffects of cigarettesmoking on anesthesia. AnesthProg 2000;47(4):143-50.
  • 7. Eltorai AEM, Szabo AL, Antoci V, Ventetuolo CE, Elias JA, Daniels AH, et al. Clinicaleffectiveness of incentivespirometryfortheprevention of postoperativepulmonarycomplications. RespirCare 2018;63(3):347-352.
  • 8. Möller AM, Villebro N, Pedersen T, Tönnesen H. Effect of preoperativesmokingintervention on postoperativecomplications: a randomisedclinicaltrial. Lancet 2002; 12;359(9301):114-7.
  • 9. Canet J, Mazo V. Postoperativepulmonarycomplications. MinervaAnestesiol 2010; 76(2):138-43.
  • 10. Rizzo S, Ratta L, Pilliteri PM. Pulmonarycomplicationsafterthoracicsurgery insmokersandnon-smokers. A prospectivestudy of 55 cases. MinervaChir1990;45(20):1281-5.
  • 11. Griffith KA, Sherrill DL, Siegel EM, Manolio TA, Bonekat HW, Enright PL. Predictors of loss of lungfunction in theelderly: theCardiovascularHealthStudy. Am J RespirCritCareMed 2001; 163(1):61-8.
  • 12. Joos L, He JQ, Shepherdson MB, Connett JE, Anthonisen NR, Paré PD, et al. The role of matrixmetalloproteinasepolymorphisms in the rate of decline in lungfunction. Hum MolGenet 2002;11(5):569-76.
  • 13. Amara CE, Koval JJ, Paterson DH, Cunningham DA. Lungfunction in olderhumans: thecontribution of body composition, physicalactivityandsmoking. Ann Hum Biol 2001;28(5):522-36.
  • 14. Upton MN, Ferrell C, Bidwell C, McConnachie A, Goodfellow J, Davey Smith G, etal. Improvingthequality of spirometry in an epidemiologicalstudy: TheRenfrew-Paisley (Midspan) familystudy. PublicHealth 2000;114(5):353-60.
  • 15. Aparici M, FernándezGonzález AL, Alegría E. Respiratoryfunctiontests.Differencesbetweensmokersandnon-smokers. Effects of withdrawal. RevClinEsp1993; 192(4):169-72.
  • 16. Sherrill DL, Lebowitz MD, Knudson RJ, Burrows B. Longitudinalmethodsfordescribingtherelationshipbetweenpulmonaryfunction, respiratorysymptomsandsmoking in elderlysubjects: theTucsonStudy. EurRespir J 1993;6(3):342-8.
  • 17. Overend TJ, Anderson CM, Lucy SD, et al. Theeffect of incentivespirometry on postoperativepulmonarycomplications: a systematicreview. Chest 2001; 120: 971–8.
  • 18. Pasquina P, Tramèr MR, Granier JM, Walder B.Respiratoryphysiotherapytopreventpulmonarycomplicationsafterabdominalsurgery: a systematicreview. Chest 2006;130 (6) 1887- 1899.
  • 19. Fagevik OM, Hahn I, Nordgren S, Lonroth H, Lundholm K. Randomizedcontrolledtrial of prophylacticchestphysiotherapy in majorabdominalsurgery. Br J Surg1997;84(11):1535-8.
  • 20. Zileli İ, Bilir M, Akalın M, Sipahi S, Zileli F, Karayel T. TheEffects Of RespiratoryExercises On PulmonaryFunctionsInPatientsWithDuchenneMuscularDystrophy. Solunum 1999;1(2):59-65.
  • 21. Westerdahl E, Lindmark B, Almgren SO, Tenling A. Chestphysiotherapyaftercoronaryartery bypass graftsurgery: A comparison of threedifferentdeepbreathingtechniques. J RehabilMed 2001;33(2):79-84.
  • 22. Overend TJ, Anderson CM, Lucy SD, Bhatia C, Jonsson B, Timmermans C. Theeffect of incentivespirometry on postoperativepulmonarycomplications. A systematicreview. Chest 2001;120(3):971-8.
  • 23. Li P, Li J, Wang Y, Xia J, Liu X.Effects of ExerciseIntervention on PeripheralSkeletalMuscle in StablePatientsWith COPD: A SystematicReviewand Meta-Analysis. Front Med (Lausanne) 2021; 18(8): 766841.

Effects of postoperative three-balls respiratory exercise on respiratory function tests in smoking patients who underwent extremity surgery under generel anesthesia.

Yıl 2023, Cilt: 3 Sayı: 1, 25 - 31, 27.04.2023
https://doi.org/10.58961/hmj.1229707

Öz

Aim:Incentive spirometry is used to reduce pulmonary complications after surgical interventions under general anesthesia. In this study, we aimed to investigate the effect of postoperative incentive spirometry on pulmonary function tests in patients who smoke and undergo extremity surgery under general anesthesia.
Study design: Eighty patients with ASA I-II physiological score, aged 18-61 years, who underwent extremity operation in a 3rd level hospital were included in the study. After the patients were divided into two groups as 40 patients in each group, smokers of 10-20 cigarettes per day for at least 5 years and non-smokers and the groups were once more randomized according to whether they would use incentive spirometry (three balls of breathing exercise) or not. Group K (n=20):Non-smoker and not using incentivespirometry, Group T (n=20): Non-smoker and using incentivespirometry, Group S (n=20): Smoker of 10-20 cigarettes per day for at least 5 years andnot using incentive spirometry, Group ST (n=20): Smokers of 10-20 cigarettes per day for at least 5 years and using incentive spirometry.
Results:The demographic data similar between the groups. When the groups were compared in terms of preoperative and postoperative FVC and FEV1 values, the postoperative FVC values in Group K and Group S were found to be significantly lower than the preoperative values (p=0.001, p=0.002, respectively). Postoperative PEF values were significantly lower than preoperative values (p=0.024, p=0.024, p=0.001, respectively). When compared within groups, postoperative VC values in Group K and Group S were found to be significantly lower than preoperative values (p=0.037, p=0.012, respectively). When the groups were compared statistically in terms of preoperative and postoperative FEV1/FVC values, no significant difference was found (p>0.05).
Conclusion:It was found that postoperative worsening of respiratory function test values in smokers who received general anesthesia has improved with the use of incentive spirometry. For this reason, it is assumed that the use of incentivespirometry in the postoperative period in extremity operations performed under general anesthesia will be helpful in preventing postoperative respiratory complications.

Kaynakça

  • 1. Restrepo RD, Wettstein R, Wittnebel L, Tracy M; AmericanAssociationforRespiratoryCare. AARC ClinicalPracticeGuideline. Incentivespirometry. RespirCare 2011;56(10):1600-1604.
  • 2. Carvalho CR, Paisani DM, Lunardi AC. Incentivespirometry in majör surgeries: a systematicreview. RevBrasFisioter 2011;15(5):343-350.
  • 3. Cassidy MR, Rosenkranz P, McCabe K, Rosen JE, McAneny D. I COUGH: Reducingpostoperativepulmonarycomplicationswith a multidisciplinarypatientcare program. JAMA Surg 2013;148(8):740-745.
  • 4. Paiva DN, Assmann LB, Bordin DF, et al. Inspiratorymuscletrainingwiththresholdorincentivespirometry: Which is themosteffective? RevistaPortuguesa de Pneumologia (English Edition). 2015;21:76–81. 5. Peirovifar A. Effects of passiveandactivesmoking on induction of anesthesia, MedicalFacultyJournal of GuilanUniversity of MedicalSciences 2002;1:42.
  • 6. Rodrigo C. Theeffects of cigarettesmoking on anesthesia. AnesthProg 2000;47(4):143-50.
  • 7. Eltorai AEM, Szabo AL, Antoci V, Ventetuolo CE, Elias JA, Daniels AH, et al. Clinicaleffectiveness of incentivespirometryfortheprevention of postoperativepulmonarycomplications. RespirCare 2018;63(3):347-352.
  • 8. Möller AM, Villebro N, Pedersen T, Tönnesen H. Effect of preoperativesmokingintervention on postoperativecomplications: a randomisedclinicaltrial. Lancet 2002; 12;359(9301):114-7.
  • 9. Canet J, Mazo V. Postoperativepulmonarycomplications. MinervaAnestesiol 2010; 76(2):138-43.
  • 10. Rizzo S, Ratta L, Pilliteri PM. Pulmonarycomplicationsafterthoracicsurgery insmokersandnon-smokers. A prospectivestudy of 55 cases. MinervaChir1990;45(20):1281-5.
  • 11. Griffith KA, Sherrill DL, Siegel EM, Manolio TA, Bonekat HW, Enright PL. Predictors of loss of lungfunction in theelderly: theCardiovascularHealthStudy. Am J RespirCritCareMed 2001; 163(1):61-8.
  • 12. Joos L, He JQ, Shepherdson MB, Connett JE, Anthonisen NR, Paré PD, et al. The role of matrixmetalloproteinasepolymorphisms in the rate of decline in lungfunction. Hum MolGenet 2002;11(5):569-76.
  • 13. Amara CE, Koval JJ, Paterson DH, Cunningham DA. Lungfunction in olderhumans: thecontribution of body composition, physicalactivityandsmoking. Ann Hum Biol 2001;28(5):522-36.
  • 14. Upton MN, Ferrell C, Bidwell C, McConnachie A, Goodfellow J, Davey Smith G, etal. Improvingthequality of spirometry in an epidemiologicalstudy: TheRenfrew-Paisley (Midspan) familystudy. PublicHealth 2000;114(5):353-60.
  • 15. Aparici M, FernándezGonzález AL, Alegría E. Respiratoryfunctiontests.Differencesbetweensmokersandnon-smokers. Effects of withdrawal. RevClinEsp1993; 192(4):169-72.
  • 16. Sherrill DL, Lebowitz MD, Knudson RJ, Burrows B. Longitudinalmethodsfordescribingtherelationshipbetweenpulmonaryfunction, respiratorysymptomsandsmoking in elderlysubjects: theTucsonStudy. EurRespir J 1993;6(3):342-8.
  • 17. Overend TJ, Anderson CM, Lucy SD, et al. Theeffect of incentivespirometry on postoperativepulmonarycomplications: a systematicreview. Chest 2001; 120: 971–8.
  • 18. Pasquina P, Tramèr MR, Granier JM, Walder B.Respiratoryphysiotherapytopreventpulmonarycomplicationsafterabdominalsurgery: a systematicreview. Chest 2006;130 (6) 1887- 1899.
  • 19. Fagevik OM, Hahn I, Nordgren S, Lonroth H, Lundholm K. Randomizedcontrolledtrial of prophylacticchestphysiotherapy in majorabdominalsurgery. Br J Surg1997;84(11):1535-8.
  • 20. Zileli İ, Bilir M, Akalın M, Sipahi S, Zileli F, Karayel T. TheEffects Of RespiratoryExercises On PulmonaryFunctionsInPatientsWithDuchenneMuscularDystrophy. Solunum 1999;1(2):59-65.
  • 21. Westerdahl E, Lindmark B, Almgren SO, Tenling A. Chestphysiotherapyaftercoronaryartery bypass graftsurgery: A comparison of threedifferentdeepbreathingtechniques. J RehabilMed 2001;33(2):79-84.
  • 22. Overend TJ, Anderson CM, Lucy SD, Bhatia C, Jonsson B, Timmermans C. Theeffect of incentivespirometry on postoperativepulmonarycomplications. A systematicreview. Chest 2001;120(3):971-8.
  • 23. Li P, Li J, Wang Y, Xia J, Liu X.Effects of ExerciseIntervention on PeripheralSkeletalMuscle in StablePatientsWith COPD: A SystematicReviewand Meta-Analysis. Front Med (Lausanne) 2021; 18(8): 766841.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Anesteziyoloji
Bölüm Araştırma Makaleleri
Yazarlar

Muzaffer Şenveli 0000-0003-2955-7243

Alkin Çolak 0000-0001-9103-4844

Makbule Elif Yılmaz 0000-0001-5121-4066

Sevtap Hekimoglu Sahin 0000-0002-3223-531X

Fatma Nesrin Turan 0000-0002-1794-2585

Yayımlanma Tarihi 27 Nisan 2023
Gönderilme Tarihi 5 Ocak 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 3 Sayı: 1

Kaynak Göster

Vancouver Şenveli M, Çolak A, Yılmaz ME, Hekimoglu Sahin S, Turan FN. Effects of postoperative three-balls respiratory exercise on respiratory function tests in smoking patients who underwent extremity surgery under generel anesthesia. HTD / HMJ. 2023;3(1):25-31.

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