Supervised Immediate Postoperative Mobilization After Elective Colorectal Surgery: A Feasibility Study

Area of Science:

• Surgical Recovery
• Postoperative Care
• Patient Mobility

Background:

• Early mobilization is crucial in Enhanced Recovery After Surgery (ERAS) guidelines, recommending 2 hours out of bed daily.
• The safety and feasibility of immediate mobilization post-colorectal surgery remain under-investigated.
• This study addresses the gap by evaluating near-immediate structured mobilization post-colorectal surgery.

Purpose of the Study:

• To assess the feasibility of initiating structured, supervised mobilization 30 minutes post-colorectal surgery.
• To evaluate the safety of this early mobilization protocol in the Postoperative Anesthesia Care Unit (PACU).
• To describe patient responses and any barriers to immediate postoperative mobilization.

Main Methods:

• A feasibility study involving 42 adult patients undergoing elective colorectal surgery.
• Utilized a modified Surgical ICU Optimal Mobilization Score (SOMS) for structured mobilization.
• Mobilization success defined as reaching SOMS level ≥2 (sitting on bed edge).

Main Results:

• 71% of patients achieved their highest mobilization level within 2-3 hours of PACU arrival.
• 43% could stand, and 38% could ambulate before ward transfer.
• Delayed mobilization was attributed to pain, somnolence, hypotension, nausea, and patient refusal; no serious adverse events occurred.

Conclusions:

• Structured, supervised mobilization is feasible and safe in the immediate postoperative period following colorectal surgery.
• This approach can be safely initiated in the PACU.
• Supports the integration of very early mobilization into enhanced recovery protocols.