Impact of laparoscopic surgery on thoracoabdominal mechanics and inspiratory muscular activity
Carregando...
Citações na Scopus
14
Tipo de produção
article
Data de publicação
2013
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE BV
Citação
RESPIRATORY PHYSIOLOGY & NEUROBIOLOGY, v.186, n.1, p.40-44, 2013
Resumo
Objective: To evaluate the effect of laparoscopic surgery on pulmonary volume distributions and inspiratory muscles activity. Respiratory consequences associated with postoperative pain were also evaluated. Methods: This study enrolled 20 patients without lung disease performed spirometry and chest wall kinematic analyses (i.e., chest wall, upper and lower ribcage and abdominal volumes), and measured the activity of inspiratory muscular before and 2 days after laparoscopic surgery. Pain was also assessed. Results: After laparoscopy, the patients demonstrated decreased volumes in all three thoracoabdominal compartments: abdomen (ABD), upper and lower rib cage (URC and LRC, respectively) compared with the pre-operative measurements: ABD = 0.38 +/- 0.20 L vs. 0.55 +/- 0.25 L; URC = 0.45 +/- 0.18 L vs. 0.55 +/- 0.21 L; and LRC = 0.31 +/- 0.18 L vs. 0.41 +/- 0.23 L; p <0.05. A reduction in the inspiratory muscular activity after surgery was also observed (sternocleidomastoid: 10.6 +/- 5.1 x 10(-3) mV vs. 12.8 +/- 6.3 x 10(-3) my; intercostals: 16.8 +/- 12.4 x 10(-3) mV vs. 25.1 +/- 21.3 x 10(-3) my; p <0.05). In addition, lower volumes during deep breathing were observed in patients who reported significant pain than those who did not (0.51 +/- 0.17 L vs. 0.79 +/- 0.29 L; p <0.05, respectively). Conclusion: Laparoscopic surgery reduces chest wall ventilation and inspiratory muscular activity during deep breathing. The effects appear to depend on the patient's reported pain level.
Palavras-chave
Surgery, Respiratory muscles, Pulmonary ventilation, Electromyography, Plethysmography
Referências
- AGOSTONI E, 1966, J APPL PHYSIOL, V21, P1827
- Aliverti A, 2009, EUR RESPIR J, V33, P49, DOI 10.1183/09031936.00141607
- Aliverti A., 2006, CRIT CARE, V10, P1
- Arozullah AM, 2003, MED CLIN N AM, V87, P153, DOI 10.1016/S0025-7125(02)00151-7
- Ayoub J, 2001, ANESTH ANALG, V92, P755
- Bapoje SR, 2007, CHEST, V132, P1637, DOI 10.1378/chest.07-0347
- Breivik H, 2008, BRIT J ANAESTH, V101, P17, DOI 10.1093/bja/aen103
- Damiani G, 2008, DIGEST SURG, V25, P1, DOI 10.1159/000114193
- De Luca CJ, 1997, J APPL BIOMECH, V13, P135
- Durkin JL, 2005, J ELECTROMYOGR KINES, V15, P474, DOI 10.1016/j.jelekin.2005.02.003
- ERICE F, 1993, ANESTHESIOLOGY, V79, P966, DOI 10.1097/00000542-199311000-00015
- Hedenstierna G, 2005, INTENS CARE MED, V31, P1327, DOI 10.1007/s00134-005-2761-7
- Hermens HJ, 2000, J ELECTROMYOGR KINES, V10, P361, DOI 10.1016/S1050-6411(00)00027-4
- Kallenberg L.A., 2009, J ELECTROMYOGR KINES, V19, P536
- Kanat F, 2007, ANZ J SURG, V77, P135, DOI 10.1111/j.1445-2197.2006.03993.x
- Karagulle E, 2008, SURG LAPARO ENDO PER, V18, P329, DOI 10.1097/SLE.0b013e31816feee9
- Kawamura H, 2008, SURG ENDOSC, V22, P81, DOI 10.1007/s00464-007-9373-y
- Kawamura H, 2010, SURG ENDOSC, V24, P2739, DOI 10.1007/s00464-010-1037-7
- Kimball WR, 2008, J CLIN ANESTH, V20, P200, DOI 10.1016/j.jclinane.2007.10.009
- Kodera Y, 2010, J AM COLL SURGEONS, V211, P677, DOI 10.1016/j.jamcollsurg.2010.07.013
- Koivusalo AM, 2008, SURG ENDOSC, V22, P61, DOI 10.1007/s00464-007-9300-2
- La Pena M., 2002, ARCH BRONCONEUMOL, V38, P72
- Lawrence VA, 2006, ANN INTERN MED, V144, P596
- Maarsingh EJW, 2000, J APPL PHYSIOL, V88, P1955
- Miller MR, 2005, EUR RESPIR J, V26, P319, DOI 10.1183/09031936.05.00034805
- Paisani D. M., 2012, RESP CARE
- Pereira CAC, 2002, J PNEUMOL S3, V28, P1
- Roumm Adam R, 2005, Surg Innov, V12, P261, DOI 10.1177/155335060501200313
- Smetana Gerald W, 2009, Cleve Clin J Med, V76 Suppl 4, pS60, DOI 10.3949/ccjm.76.s4.10
- Wang HK, 2009, J FORMOS MED ASSOC, V108, P577, DOI 10.1016/S0929-6646(09)60376-4