An observational study on effect of breathing exercise on quality of recovery among postoperative patients

Chaudhary, Anuradha; Shukla, Samir; Sairker, Devanand; Sharma, Mohit; Singh, Siddharth; Patta, Nitin; Kandpal, Mayank; Soni, Murari Lal

doi:10.61186/rabms.9.4.254

Volume 9, Issue 4 (10-2023) Journal of Research in Applied and Basic Medical Sciences 2023, 9(4): 254-262 | Back to browse issues page

‎ 10.61186/rabms.9.4.254

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Chaudhary A, Shukla S, Sairker D, Sharma M, Singh S, Patta N, et al . An observational study on effect of breathing exercise on quality of recovery among postoperative patients. Journal of Research in Applied and Basic Medical Sciences 2023; 9 (4) :254-262
URL: http://ijrabms.umsu.ac.ir/article-1-274-en.html

An observational study on effect of breathing exercise on quality of recovery among postoperative patients

Anuradha Chaudhary

, Samir Shukla

, Devanand Sairker ^*

Resident Surgical Officer, Department of General Surgery, Gandhi Medical College and Associated Hamidia Hospital, Bhopal (M.P.), India 462001 , devsairker@gmail.com

Abstract: (650 Views)

Background & Aims: Breathing exercises after surgery are crucial in avoiding respiratory complications. These exercises have proven highly effective in improving the recovery quality of post-operative patients. Despite their widespread use in patient care, there is a lack of scientific evidence to prove their effectiveness. Therefore, the current study aims to evaluate the influence of deep breathing exercises on the quality of postoperative recovery in the patients who have undergone emergency surgery.
Materials & Methods: A randomized controlled trial was performed to evaluate the efficiency of deep breathing exercises in post-operative patients who had emergency surgery. The study included 200 participants who met the inclusion and exclusion criteria, with 100 assigned to the experimental group as Group-A and 100 to the control group as Group-B. The patients in the experimental group were taught and practiced deep breathing exercises, while those in the control group received standard treatment. Data were gathered and analysed to compare the SpO₂ level, FVC, FEV1, PEFR, FMEF 25/75%, hospital stay, postoperative complications, and quality of recovery between the two groups. SPSS v.21 was used for the appropriate statistical analysis to check statistical differences between the proportions, and p˂0.05 considered statistically significant.
Results: The FEV1, FVC, and PFER (25-75%) reduced and did not differ significantly between the two groups, whereas SpO2 level at the 5^th day and hospital stay were significantly different in Group-B. Patient with deep breathing exercise (Group-B) did not develop any respiratory complication and had a higher postoperative quality of recovery as compared to Group-A.
Conclusion: We found that that incorporating deep breathing exercises after surgery can also increase lung capacity, prevent post-operative complications, shorten recovery time, and enhance overall quality of life.

Keywords: Deep Breathing Exercise, Emergency Surgery, Post-Operative Pulmonary complications, Post-Operative Quality of Recovery

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Type of Study: orginal article | Subject: Other

References

1. Tripathi S, Sharma R. Deep Breathing Exercise and Its Outcome among Patient with Abdominal Surgery: A Pilot Study. Int J Nurs Sci 2017;7(5):103-6 [Google Scholar]

2. Celli BR. Perioperative respiratory care of the patient undergoing upper abdominal surgery. Clin Chest Med 1993;14(2):253-61. [DOI:10.1016/S0272-5231(21)00889-3] [PMID]

3. Ayoub J, Cohendy R, Prioux J, Ahmaidi S, Bourgeois JM, Dauzat M, et al. Diaphragm Movement Before and After Cholecystectomy: A Sonographic Study. Anesth Analg 2001;92(3):755-61. [DOI:10.1097/00000539-200103000-00038] [PMID]

4. Hall JC, Tarala RA, Hall JL, Mander J. A multivariate analysis of the risk of pulmonary complications after laparotomy. Chest 1991;99(4):923-7. [DOI:10.1378/chest.99.4.923] [PMID]

5. Warner DO. Preventing postoperative pulmonary complications: the role of the anesthesiologist. Anesthesiology 2000;92(5):1467-72. Available from: http://dx.doi.org/10.1097/00000542-200005000-00037. [DOI:10.1097/00000542-200005000-00037] [PMID]

6. Kanat F, Golcuk A, Teke T, Golcuk M. Risk factors for postoperative pulmonary complications in upper abdominal surgery. ANZ J Surg 2007;77(3):135-41. [DOI:10.1111/j.1445-2197.2006.03993.x] [PMID]

7. Arozullah AM, Henderson WG, Khuri SF, Daley J. Postoperative mortality and pulmonary complication rankings: How well do they correlate at the hospital level? Med Care 2003;41(8):979-91. [DOI:10.1097/00005650-200308000-00011] [PMID]

8. Grams ST, Ono LM, Noronha MA, Schivinski CIS, Paulin E. Breathing exercises in upper abdominal surgery: a systematic review and meta-analysis. Brazilian J Phys Ther 2012;16(5):345-53. [DOI:10.1590/S1413-35552012005000052] [PMID]

9. Hussein EE, Taha NM. Effect of Breathing Exercises on Quality of Recovery Among Postoperative Patients. Int J Stud Nurs 2018;3(3):151. [DOI:10.20849/ijsn.v3i3.525]

10. Jenkins SC, Soutar SA, Moxham J. The Effects of Posture on Lung Volumes in Normal Subjects and in Patients Pre- and Post-coronary Artery Surgery. Physiother 1988;74(10):492-6. [DOI:10.1016/S0031-9406(10)63381-0]

11. Ingwersen UM, Larsen KR, Bertelsen MT, Kiil-Nielsen K, Laub M, Sandermann J, et al. Three different mask physiotherapy regimens for prevention of post-operative pulmonary complications after heart and pulmonary surgery. Intensive Care Med 1993;19(5):294-8. [DOI:10.1007/BF01690551] [PMID]

12. Crowe JM, Bradley CA. The effectiveness of incentive spirometry with physical therapy for high-risk patients after coronary artery bypass surgery. Phys Ther 1997;77(3):260-8. [DOI:10.1093/ptj/77.3.260] [PMID]

13. Milgrom LB, Brooks JA, Qi R, Bunnell K, Wuestefeld S, Beckman D. Pain levels experienced with activities after cardiac surgery. Am J Crit Care 2004;13(2):116-25. [DOI:10.4037/ajcc2004.13.2.116] [PMID]

14. Meyerson J, Thelin S, Gordh T, Karlsten R. The incidence of chronic post-sternotomy pain after cardiac surgery - A prospective study. Acta Anaesthesiol Scand 2001;45(8):940-4. [DOI:10.1034/j.1399-6576.2001.450804.x] [PMID]

15. Pryor JA, Prasad SA. Physiotherapy for Respiratory and Cardiac Problems: Adults and Paediatrics. 4th ed. Edinburgh: Churchill Livingstone; 2005. [URL]

16. Brasher PA, McClelland KH, Denehy L, Story I. Does removal of deep breathing exercises from a physiotherapy program including pre-operative education and early mobilisation after cardiac surgery alter patient outcomes? Aust J Physiother 2003;49(3):165-73. [DOI:10.1016/S0004-9514(14)60236-1] [PMID]

17. Olsén MF, Lindstrand H, Broberg JL, Westerdahl E. Measuring chest expansion; A study comparing two different instructions. Adv Physiother 2011;13(3):128-32. [DOI:10.3109/14038196.2011.604349]

18. Lawrence VA, Cornell JE, Smetana GW. Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: Systematic review for the American College of Physicians. Ann Intern Med 2006;144(8):596-608. [DOI:10.7326/0003-4819-144-8-200604180-00011] [PMID]

19. Westerdahl E, Olsén MF. Chest physiotherapy and breathing exercises for cardiac surgery patients in Sweden - A national survey of practice. Monaldi Arch Chest Dis - Pulm Ser 2011;75(2):112-9. [DOI:10.4081/monaldi.2011.223] [PMID]

20. Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G. Postoperative pulmonary function after laparoscopic and open cholecystectomy. Br J Anaesth 1996;77(4):448-52. [DOI:10.1093/bja/77.4.448] [PMID]

21. Hedenstierna G. Mechanisms of postoperative pulmonary dysfunction. Acta Chir Scand Suppl 1989;155(550):152-8. [Google Scholar]

22. Hardy KA, Bach JR, Stoller JK, Hill NS, Make B, Celli BR, et al. A review of airway clearance: New techniques, indications, and recommendations. Respir Care 1994;39(5):440-55. [Google Scholar]

23. Rose DK, Byrick RJ, Cohen MM, Caskennette GM. Planned and unplanned postoperative admissions to critical care for mechanical ventilation. Can J Anaesth 1996;43(4):333-40. [DOI:10.1007/BF03011710] [PMID]

24. Fairshter RD, Williams JH. Pulmonary Physiology in the Postoperative Period. Crit Care Clin 1987;3(2):287-306. [DOI:10.1016/S0749-0704(18)30547-5] [PMID]

25. Wren SM, Martin M, Yoon JK, Bech F. Postoperative Pneumonia-Prevention Program for the Inpatient Surgical Ward. J Am Coll Surg 2010;210(4):491-5. [DOI:10.1016/j.jamcollsurg.2010.01.009] [PMID]

26. Duggan M, Kavanagh BP. Pulmonary atelectasis: A pathogenic perioperative entity. Anesthesiol 2005;102(4):838-54. [DOI:10.1097/00000542-200504000-00021] [PMID]

27. Tahir AH, George RB, Weill H, Adriani J. Effects of abdominal surgery upon diaphragmatic function and regional ventilation. Int Surg 1973;58(5):337-40. [PMID]

28. Chuter TAM, Weissman C, Mathews DM, Starker PM. Diaphragmatic breathing maneuvers and movement of the diaphragm after cholecystectomy. Chest 1990;97(5):1110-4. [DOI:10.1378/chest.97.5.1110] [PMID]

29. Inal-Ince D, Savci S, Topeli A, Arikan H. Active cycle of breathing techniques in non-invasive ventilation for acute hypercapnic respiratory failure. Aust J Physiother 2004;50(2):67-73. [DOI:10.1016/S0004-9514(14)60098-2] [PMID]

30. Stessel B, Fiddelers AA, Joosten EA, Hoofwijk DMN, Gramke HF, Buhre WFFA. Prevalence and predictors of quality of recovery at home after day surgery. Med (United States) 2015;94(39):e1553. [DOI:10.1097/MD.0000000000001553] [PMID] []

31. Bozorg-Nejad M, Azizkhani H, Mohaddes Ardebili F, Mousavi SK, Manafi F, Hosseini AF. The Effect of Rhythmic Breathing on Pain of Dressing Change in Patients with Burns Referred to Ayatollah Mousavi Hospital. World J Plast Surg 2018;7(1):51-7. [PMID]