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Prophylactic Chest Physiotherapy in Major Abdominal Surgery among Elderly Patients
ML Lohiya1, Ajay Malviya2, Dinesh Dutt Sharma3, Sahi Ram4, MK Chauhan5, Lovedeep Singh Chauhan6
1 Principal Specialist, Dept. of General Surgery, Dr. S.N. Medical College, Jodhpur, India
2 Senior Professor and HOD, Dept. of General Surgery, Dr. S.N. Medical College, Jodhpur, India
3 Assistant Professor, Dept. of General Surgery, Dr. S.N. Medical College, Jodhpur, India
4 Consultant Surgeon, Dept. of General Surgery, Dr. S.N. Medical College, Jodhpur, India
5 Ex. Senior Professor and HOD, Dept. of General Surgery, Dr. S.N. Medical College, Jodhpur, India
6 Third Year Resident, Dept. of General Surgery, Dr. S.N. Medical College, Jodhpur, India
Correspondence Address:
Dinesh Dutt Sharma
185, Kamala Nehru Nagar, Chopasani Road, Pakiza Chakki Ke Pass, Aakhaliya Choraha, Jodhpur. 342001
India
 Source of Support: None, Conflict of Interest: None
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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.
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