logo
logo
Sign in

RESPIRATORY GYMNASTICS IN PATIENTS UNDERSTANDING ABDOMINAL SURGERY: AN ACT OF PERSONAL RESPONSIBILITY

avatar
Raz Smith
RESPIRATORY GYMNASTICS IN PATIENTS UNDERSTANDING ABDOMINAL SURGERY: AN ACT OF PERSONAL RESPONSIBILITY

A severe complication of patients who undergo abdominal surgery as a part of general surgery, and in particular in those who undergo surgery for the correction of large hernias or laparoceles, is respiratory, and affects 10 to 50% of the operated.

THE CAUSES OF RESPIRATORY COMPLICATIONS

They mainly intervene for two reasons:

  • Because the inadequate intra-abdominal containment of the herniated viscera causes a progressive reduction of intra-abdominal pressure, simultaneously reducing the muscle tone of the diaphragm and therefore its contraction force
  • For the general repercussions that the defect has on the patient, creating disability, loss of autonomy, limitation in daily activities, and therefore reducing physical quality and limiting respiratory mechanics

 By the time the abdominal wall and the contents of the abdominal cavity are surgically restored to normal, the diaphragm and respiratory muscles must contract more to overcome pressures they were no longer used to.

For this reason, a worsening of pulmonary expansion can occur, consequently exposing the patient to an increased risk of pulmonary atelectasis and, even more serious, of pneumonia.

THE IMPORTANCE OF PERI-OPERATIVE RESPIRATORY TRAINING

A peri-operative respiratory training allows to significantly reduce these important complications that weigh on the patient's prognosis.

The task of health professionals is to instruct patients, candidates for abdominal surgery, in simple RESPIRATORY PHYSIOTHERAPY exercises.

The treatment process is identified in three peri-operative phases, which are:

  • The period between the outpatient surgical visit (in which the diagnosis and surgical proposal are made) and the time of admission
  • Hospitalization (during which the surgical act itself takes place) and the postoperative days that end with discharge
  • Convalescence

During all three phases, some specific exercises are foreseen, and desirable, which, as we have seen, are extremely functional in reducing the aforementioned respiratory complications.

WHAT ARE THE BREATHING TECHNIQUES WE ADOPT

The breathing exercises that are taught to patients are often accompanied by a weight loss of body weight, which strengthens the overall well-being of the organism of the operated patient.

They are:

  • Controlled breathing
  • Breathe in through the nose and out through the mouth, effortlessly, slowly; the movement of the abdomen is felt more and it expands when you inhale.
  • Chest expansion
  • Breathe in slowly through the nose, completely filling the lungs, counting to six and then, although unable to inhale further, continue to count to 10. Then exhale slowly from the mouth as if you were to cool a spoonful of hot broth.
  • Forced exhalation
  • Repeat the inhalation as described in the chest expansion; the exhalation takes place through the open mouth until there is no more air to expel, as if you wanted to mist a glass.

Incentivatore spirometrico o Coach:

It is a tool that is delivered at pre-hospitalization or at the hospitalization itself, the operation of which is explained in detail by the healthcare staff.

Here are some explanatory points on how the coach works; these gymnastics should be performed 4 times a day for 10 repetitions each.

Step 1: Exhale all the air.

Step 2: Placing the mouthpiece firmly between your teeth, you then begin to inhale slowly and deeply.

Step 3: While inhaling, make sure that the smiley face remains colored by the yellow disc, which moves according to the speed of the inhaled air flow.

PEP (positive expiratory pressure)

It is an instrument delivered in the ward but reproducible at home with the aim of opening the alveoli. A rubber tube 80 cm long with a diameter of 1 cm is inserted up to the bottom of a bottle filled with water for 6 cm. You always breathe in through your nose and after holding your breath for 4/5 seconds you slowly blow into the tube to make the water gurgle in the bottle.

The first three techniques, free body, are reproduced during the first phase, pre-operative; they are subsequently assisted by the aid of special tools and by the fundamental work of physiotherapists during the period of hospitalization, to then be resumed in the period of convalescence when the exercises already acquired previously will be performed at home.

collect
0
avatar
Raz Smith
guide
Zupyak is the world’s largest content marketing community, with over 400 000 members and 3 million articles. Explore and get your content discovered.
Read more