[Inverse relationship between age and pulmonary function decline in the postoperative period of laparoscopic...

Abnormal lung mechanics with diminution of pulmonary volumes and airflows is an adverse effect occurring during the immediate postoperative period of the upper-abdomen surgery.

To evaluate the influence of age on the lung function decline occurring during the immediate postoperative period of laparascopic cholecystectomy.

Patients planned to be submitted to elective laparoscopic cholecystectomy were recruited from July to November 2000. A first basal spirometric study was performed the day before surgery and a second one between 21 and 27 h after surgery.

Twenty three patients (3 men) aged 22 to 81 years old were studied. Patients had a significant drop of pulmonary function in the immediate postoperative period. There was a statistically significant inverse correlation between age and the degree of postoperative decline of the forced expiratory volume at one second (FEV1, r = -0.54, p < 0.01), the midexpiratory flow (FEF25-75, r = -0.48, p < 0.05), and the peak expiratory flow (PEF, r = - 0.49, p < 0.05).

Our results suggest that age is inversely related to the pulmonary function decline observed one day after laparoscopic cholecystectomy, which might be explained by the increment of the pain threshold or the decrease of postoperative inhibitory reflexes occurring with aging.