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

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Early mobilization after colorectal surgery is feasible and safe. Structured, supervised mobilization starting 30 minutes post-surgery in the PACU allows patients to safely progress to sitting or ambulating, enhancing recovery.

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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.