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Clinical InvestigationsPostthoracotomy Respiratory Muscle Mechanics During Incentive Spirometry Using Respiratory Inductance Plethysmography
Section snippets
Subjects
Sixteen patients, 11 men and 5 women, scheduled for elective thoracotomy were studied. Informed consent was obtained from all subjects according to the guidelines of the Institutional Review Board of Memorial Sloan-Kettering Cancer Center. Patients were excluded from participation in the study if they were concomitantly suffering from a severely debilitating medical or psychiatric illness, weighed under 50 kg or over 100 kg, or found to have a pleural effusion. Patients ranged in age from 30 to
RESULTS
There were no significant differences between the populations in height, weight, age, percent predicted FVC and FEV1/FVC at 30° and 60° angle of inclination (Table 1). The postoperative pain score prior to the study sessions averaged 2.1 ±0.6 ranging from 1 to 5. There was no significant difference in pain scores on postoperative day 1 and day 3. Total daily doses of morphine sulphate administered was greater on postoperative day 1 than on day 3 (0.42 ±0.01 mg/kg vs 0.17 ±0.01 mg/kg,
DISCUSSION
Respiratory complications remain the most important cause of postoperative morbidity following thoracotomy. Previous investigators have shown that between 10 and 50 percent of patients who have undergone thoracic surgery have evidence of postoperative pulmonary abnormalities.15, 16 Incentive spirometry is one of the mechanical aids used to increase lung volume and reduce the incidence of such complications.6 This study characterizes the global respiratory mechanical changes that occur during
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This study was supported by a starter grant from the Society of Cardiovascular Anesthesiologists.