Efeitos na força muscular inspiratória, mecânica respiratória, funcionalidade e dor em pacientes submetidos à laparatomia exploradora

Abstract

Upper abdominal surgeries are associated with severe complications that hinder patient recovery. Postoperative pulmonary complications (PPCs) are the main contributors to high morbidity and mortality rates. The objectives were to evaluate pulmonary strength and function, pain, and functionality in patients who underwent exploratory laparotomy in order to identify possible functional changes affecting these patients in the immediate postoperative period and quantify the length of hospital stay. This was a prospective, observational, and cross-sectional study involving six patients hospitalized at the Surgical Clinic of the Regional Hospital Antônio Dias, who underwent exploratory laparotomy between October 2023 and February 2024. The variables Maximum Inspiratory Pressure (PImáx) (p=0.296), Tidal Volume (VC) (p=0.094), Respiratory Rate (FR) (p=0.530), Functionality (p=1.000), and Overall Muscle Strength (p=0.576) showed no significant differences after the intervention. However, Minute Volume (VM) (p=0.015), Peak Expiratory Flow (PFE) (p=0.025), and Pain (p=0.004) showed significant differences, with VM and PFE decreasing and pain increasing after the surgical procedure. In conclusion, abdominal surgeries had a significant impact on pulmonary ventilation variables, the occurrence of infectious complications related to both the abdominal cavity and the lungs, and an increase in pain levels, leading to the development of immobilization syndrome and extended hospital stays. These effects may be directly linked to factors such as pain, anesthesia, and the surgery itself. Therefore, physiotherapy plays a crucial role in the recovery of these patients, and the implementation of early, personalized intervention protocols, such as early mobilization and respiratory rehabilitation, is essential to mitigate medium and long-term effects. These practices led to improvements in the aforementioned parameters, a reduction in postoperative rest time and hospital stay, minimizing the occurrence of PPCs, and contributing to faster functional and respiratory recovery and an improved quality of life.