• Best Pract Res Clin Anaesthesiol · Jun 2010

    Review

    Perioperative modifications of respiratory function.

    • Michelle Duggan and Brian P Kavanagh.
    • Department of Anesthesia, Mayo General Hospital, Castlebar, Co. Mayo, Ireland. Michelle.Duggan@hse.ie
    • Best Pract Res Clin Anaesthesiol. 2010 Jun 1; 24 (2): 145-55.

    AbstractPostoperative pulmonary complications contribute considerably to morbidity and mortality, especially after major thoracic or abdominal surgery. Clinically relevant pulmonary complications include the exacerbation of underlying chronic lung disease, bronchospasm, atelectasis, pneumonia and respiratory failure with prolonged mechanical ventilation. Risk factors for postoperative pulmonary complications include patient-related risk factors (e.g., chronic obstructive pulmonary disease (COPD), tobacco smoking and increasing age) as well as procedure-related risk factors (e.g., site of surgery, duration of surgery and general vs. regional anaesthesia). Careful history taking and a thorough physical examination may be the most sensitive ways to identify at-risk patients. Pulmonary function tests are not suitable as a general screen to assess risk of postoperative pulmonary complications. Strategies to reduce the risk of postoperative pulmonary complications include smoking cessation, inspiratory muscle training, optimising nutritional status and intra-operative strategies. Postoperative care should include lung expansion manoeuvres and adequate pain control.

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