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Lung mechanics during upper abdominal surgery.

A Larsson1, C Jonmarker, O Werner

  • 1Department of Anaesthesia, University Hospital, Lund, Sweden.

Acta Chirurgica Scandinavica
|June 1, 1989
PubMed
Summary
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This study found that respiratory system compliance decreased by 15% after abdominal surgery, regardless of incision type. Functional residual capacity remained stable, suggesting intraoperative events do not explain differing complication rates.

Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Respiratory Physiology

Background:

  • Upper abdominal surgery can impact respiratory function.
  • Different surgical incision types (subcostal vs. midline) may influence postoperative pulmonary complications.

Purpose of the Study:

  • To investigate the intraoperative effects of subcostal and midline abdominal incisions on functional residual capacity (FRC) and respiratory system compliance (Crs).
  • To determine if intraoperative changes in FRC and Crs correlate with known differences in postoperative pulmonary complications between incision types.

Main Methods:

  • Functional residual capacity (FRC) and breath-by-breath compliance of the respiratory system (Crs) were measured in patients undergoing upper abdominal surgery.
  • Measurements were taken after anesthesia induction, retractor insertion, and wound closure.

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  • Patients were divided into two groups based on incision type: subcostal (n=8) and midline (n=8).

    • Main Results:

    • FRC did not significantly decrease in either the subcostal or midline incision groups during surgery.
    • Crs decreased by approximately 15% in both groups by the end of the procedure.
    • In the subcostal group, Crs fell after retractor placement (p<0.01).
    • In the midline group, Crs fell after wound closure (p<0.05) compared to baseline.

    Conclusions:

    • Intraoperative changes in FRC and Crs do not appear to explain the observed differences in postoperative pulmonary complications between subcostal and midline abdominal incisions.
    • While respiratory system compliance decreases during upper abdominal surgery, this effect is consistent across both incision types studied.