• Roberta Munhoz Manzano, Celso Ricardo Fernandes de Carvalho, Beatriz Mangueira Saraiva-Romanholo, and Joaquim Edson Vieira.
• Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil. roberta_m_m@hotmail.com
• Sao Paulo Med J. 2008 Sep 1; 126 (5): 269273269-73.

Context And ObjectiveAbdominal surgical procedures increase pulmonary complication risks. The aim of this study was to evaluate the effectiveness of chest physiotherapy during the immediate postoperative period among patients undergoing elective upper abdominal surgery.Design And SettingThis randomized clinical trial was performed in the post-anesthesia care unit of a public university hospital.MethodsThirty-one adults were randomly assigned to control (n = 16) and chest physiotherapy (n = 15) groups. Spirometry, pulse oximetry and anamneses were performed preoperatively and on the second postoperative day. A visual pain scale was applied on the second postoperative day, before and after chest physiotherapy. The chest physiotherapy group received treatment at the post-anesthesia care unit, while the controls did not. Surgery duration, length of hospital stay and postoperative pulmonary complications were gathered from patients' medical records.ResultsThe control and chest physiotherapy groups presented decreased spirometry values after surgery but without any difference between them (forced vital capacity from 83.5 +/- 17.1% to 62.7 +/- 16.9% and from 95.7 +/- 18.9% to 79.0 +/- 26.9%, respectively). In contrast, the chest physiotherapy group presented improved oxygen-hemoglobin saturation after chest physiotherapy during the immediate postoperative period (p < 0.03) that did not last until the second postoperative day. The medical record data were similar between groups.ConclusionsChest physiotherapy during the immediate postoperative period following upper abdominal surgery was effective for improving oxygen-hemoglobin saturation without increased abdominal pain. Breathing exercises could be adopted at post-anesthesia care units with benefits for patients.

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