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Physiotherapy in the perioperative period.
Nicolino Ambrosino1, Luciano Gabbrielli
1Respiratory Unit, Cardio-Thoracic Department, University Hospital, Pisa, Italy. n.ambrosino@ao-pisa.toscana.it
Best Practice & Research. Clinical Anaesthesiology
|July 9, 2010
Summary
Surgery and anesthesia can cause respiratory complications, especially after thoracic surgery in patients with COPD. Preoperative optimization and physiotherapy may improve outcomes, but evidence is limited.
Area of Science:
- Anesthesiology
- Pulmonology
- Thoracic Surgery
Background:
- Surgery and general anesthesia significantly impact the respiratory system.
- Postoperative pulmonary complications (PPCs) increase morbidity, hospital stay, and costs.
- PPCs are particularly high (up to 30%) after thoracotomy and lung resection in COPD patients.
Purpose of the Study:
- To review the impact of surgery and anesthesia on respiratory function.
- To discuss the role of preoperative optimization and physiotherapy in high-risk surgical patients.
- To highlight the limited evidence base for perioperative physiotherapy recommendations.
Main Methods:
- Review of existing literature on perioperative respiratory management.
- Analysis of factors contributing to PPCs, including respiratory muscle dysfunction and chest wall mechanics.
- Examination of evidence for preoperative optimization strategies.
Main Results:
- Surgery and anesthesia can lead to significant respiratory complications.
- Preoperative medical therapy optimization, physiotherapy, and early mobilization are suggested for high-risk patients.
- Evidence from randomized controlled trials or meta-analyses is limited.
Conclusions:
- Preoperative optimization and physiotherapy may improve outcomes in high-risk surgeries.
- Further high-quality research is needed to support recommendations for perioperative physiotherapy.
- Understanding the impact of surgical procedures on respiratory mechanics is crucial for patient management.
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