Izvorni znanstveni članak
The Effect of Analgesics and Physical Therapy on Respiratory Function after Open and Laparoscopic Cholecystectomy
Željko Mimica
Zenon Pogorelić
Darko Sršen
Zdravko Perko
Radoslav Stipić
Domagoj Dujmović
Jadranka Tocilj
Darko Ujević
Sažetak
In this study we present prospective clinical trial included 100 patients. One half of the patients underwent open
cholecystectomy, whereas laparoscopic cholecystectomy was performed in the other half. Spirometric parameters, arterial
blood gases, acid-base balance, were determined preoperatively, and then at 6 h, 24 h, 72 h and 144 h postoperatively. The
impact of physical therapy on the respiratory parameter patterns, VAS-pain score and use of tramadol were studied after
cholecystectomy. Significantly lower VAS-pain score and less tramadol use, higher values and faster recovery of ventilation
parameters and PaO2 were recorded after laparoscopic cholecystectomy than after open cholecystectomy (p=0.001 for
both). Physical therapy resulted in a significant improvement in the values of respiratory parameters in the open cholecystectomy
group within a short time (30 min) after therapy was performed. Physical therapy failed to produce any improvement
of respiratory parameters in laparoscopic cholecystectomy, whereas in open cholecystectomy group who had a favorable
although transient effect, strictly limited to the short time from its application. (p=0.005). The patients operated on by
open cholecystectomy had statistically significantly more pronounced disturbances including hypoxia, hypocapnia and hyperventilation
when compared to the group submitted to laparoscopic cholecystectomy. It is recommended that physical
therapy be more frequently performed during the postoperative period in patients submitted to open cholecystectomy
Ključne riječi
cholecystectomy; laparoscopic cholecystectomy; postoperative respiratory insufficiency; postoperative analgesia; physical therapy
Hrčak ID:
23727
URI
Datum izdavanja:
8.5.2008.
Posjeta: 1.489 *