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KMID : 0350519930460010411
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Journal of Catholic Medical College
1993 Volume.46 No. 1 p.411 ~ p.420
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The Pulmonary Function relating to the Position of the Patients following Abdominal Surgery
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Abstract
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This study is intended to investigate the relationship between the pulmonary function and the positions and to analyse the factors influencing the peak expiratory flow rate(P.E.F.R) of patients undergoing abdominal surgery. The variables used
were
the
positions-Semi Fowler´s and High Fowler´s positions-both during the prior to surgery and for 3dadys during the post-operative period.
The testing was carried out randomly among 44 patients admitted to Kangnam St. Mary´s hospital and St. Mary´s hospital from July 4 to August 4, in 1992.
The peak expiratory flow rate(P.E.F.R) was measured by a Mini-Wright Peak Flow Meter in two positions-Semi Fowler´s and High Fowler´s positions-both during the prior to surgery and for 3days during the post-operative period.
@ES The results are shown below :
@EN 1. P.E.F.R was significantly higher in high-Fowler´s position than in semi-Fowler´s position on the post-operative lst, 3rd days(P<0.1, P<.05).
2. There ws a significant difference in P.E.F.R relating to the position according to the age, sex, height, smoking history and cardiac disease history of the patients. With regard to age, P.E.F.R was significantly higher in high-Fowler´s
position
than
in semi-Fowler´s position among the 51 to 60 year age group on the lst post-operative day and 41 to 50 year ge group on the 3rd post-operative day(P<.05, P<.05). With regard to the sex, both male and female patients showed significatly higher
P.E.F.R in
high-Fowler´s position than in semi-Fowler´s on the lst post-operative day(P<.05, P<.01). With regard to the height, P.E.F.R was significantly higher in high-Fowler´s position, among thosee who were under 160cm, on the lst post-operative
day(P<.01).
With regard to smoking, patients with no smoking history showed significantly higher P.E.F.R in high-Fowler´s position than in semi-Fowler´s position on the lst, 2nd and 3rd post-operative days(P<.0.1, P<.05, P<.05). With regard to
cardio-pulmonary
disease, those with no cardio-pulmonary disease history showed significantly higher P.E.F.R in high Fowler´s position than in semi-Fowler´s position on the lst post-operative day(P<.01).
3. The statistical difference in P.E.F.R relating to the position was shown according to the type of operation, incision, anesthesia, duration of anesthesia and nasogastric tube. As for the type of operation, hepatobiliary operations showed
significantly higher P.E.F.R in high-Fowler´s position than in semi-Fowler´s position on the lst and 3rd post-operative days(P<.05, P<.05). As for the type of incisions, subcostal & low midline incisions showed higher P.E.F.R in high-Fowler´s
position
on the lst post-operative day(P<.01). Also, P.E.F.R was significantly higher in high-Fowler´s position than in semi-Fowler´s position among the patients with upper midline incision, on the 3rd post-operative day(P<.05). According to the type of
anesthesia, inhalation showed higher P.E.F.R in high-Fowler´s position than in semi-Fowler´s position on the lst post-operative day(P<.01). As for the duration of anesthesia, P.E.F.R fwas significantly higher in high-Fowler´s position than in
semi-Fowler´s position among the groups who were under anesthesia between 2 and 3 hours, between 3 and 4 hours on the lst post-operative days, between 3 and 4 hours on the 3rd post-operative day(P<.05, P<.01, P<.05). According to the nasogastric
tube,
P.E.F.R was higher in high-Fowler´s position than in semi-Fowler´s position among the patients with nasogastric tube for 3 days post-operative on the lst, 3rd post-operative days(P<.05, P<.05).
4. Sex and age appeared to be the most influencing factors in the pre-operative period age, type of anesthesia and sex in the post-operative period.
The above result suggested that patients following abdominal surgery should be kept in high-Fowler´s postion specially for 3 days during the post-operative period, since P.E.F.R was significantly higher in high-Fowler´s position than in
semi-Fowler´s
position for 3 days during the post-operative period.
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