Exercícios respiratórios no pré- operatório de abdominoplastia
Data
2018-05-31
Autores
Rodrigues, Maria Amelia 
Orientadores
Nahas, Fabio Xerfan
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A cirurgia de abdominoplastia leva à diminuição da função ventilatória e após a colocação da cinta elástica ocorre aumento da Pressão Intraabdominal (PIA). Exercícios respiratórios são utilizados no pré e pós-operatórios de diversas cirurgias abdominais e torácicas. Objetivo: Avaliar o efeito de exercícios respiratórios realizados no pré-operatório em mulheres submetidas à abdominoplastia. Métodos: Foram selecionadas 33 pacientes distribuídas em dois grupos. O grupo controle teve 18 pacientes que foram submetidas à cirurgia sem intervenção de exercícios respiratórios no préoperatório. O grupo intervenção teve 15 pacientes que foram submetidas à cirurgia e realizaram os seguintes exercícios no préoperatório: Exercícios com Inspirômetro de Incentivo, Exercícios diafragmáticos, Expiração abreviada e Inspiração Máxima Sustentada. Os exercícios foram iniciados uma semana antes da cirurgia e realizados três vezes na semana na presença de um fisioterapeuta, sendo orientado a repetilos diariamente em domicílio. A Espirometria foi realizada no préoperatório, no segundo, sétimo e décimo quinto dia de pósoperatório. A PIA foi avaliada no intraoperatório em cinco momentos. Para a análise dos resultados foram aplicados os seguintes testes: Análise de Variância (ANOVA) com Medidas Repetidas na comparação dos grupos e comparação pelo método de Bonferroni quando necessário. Resultados: Não houve diferença entre os grupos para os parâmetros da Espirometria. O grupo que realizou os exercícios teve uma menor PIA desde o início da cirurgia e esta se manteve menor em todos os momentos estudados (p=0,010). Conclusão: Os exercícios respiratórios não interferiram nos parâmetros da Espirometria. Os exercícios podem ter promovido diminuição da PIA no intraoperatório na cirurgia de abdominoplastia.
Background: After abdominoplasty, patients experience decreased ventilatory function and increased intraabdominal pressure (IAP). Breathing exercises are used during the preand postoperative periods of several abdominal surgeries to prevent or minimize postoperative complications. The aim of this study was to assess the effect of preoperative respiratory physiotherapy on the outcome of abdominoplasty patients. Methods: Thirtythree consecutive patients were divided into two groups. The control group (n = 18) received no preoperative intervention. The intervention group (n = 15) performed breathing exercises during the preoperative period, including incentive spirometry, diaphragmatic breathing, shortened expiration, and sustained maximal inspiration. Respiratory physiotherapy started one week before surgery. Breathing exercises were performed daily. They were performed threetimes weekly in the presence of a physiotherapist and patients were instructed to carry on the exercises at home on days without physiotherapy sessions for three sets of 20 repetitions each. Patients were assessed by spirometry and IAP measurements. Results: No significant difference in spirometry was found between groups. However, patients in the intervention group had lower IAP at the start of surgery and at all time points (p = 0.010) compared with controls. Conclusion: Preoperative respiratory physiotherapy had no impact on spirometry, but may have contributed to reduce IAP intraoperatively.
Background: After abdominoplasty, patients experience decreased ventilatory function and increased intraabdominal pressure (IAP). Breathing exercises are used during the preand postoperative periods of several abdominal surgeries to prevent or minimize postoperative complications. The aim of this study was to assess the effect of preoperative respiratory physiotherapy on the outcome of abdominoplasty patients. Methods: Thirtythree consecutive patients were divided into two groups. The control group (n = 18) received no preoperative intervention. The intervention group (n = 15) performed breathing exercises during the preoperative period, including incentive spirometry, diaphragmatic breathing, shortened expiration, and sustained maximal inspiration. Respiratory physiotherapy started one week before surgery. Breathing exercises were performed daily. They were performed threetimes weekly in the presence of a physiotherapist and patients were instructed to carry on the exercises at home on days without physiotherapy sessions for three sets of 20 repetitions each. Patients were assessed by spirometry and IAP measurements. Results: No significant difference in spirometry was found between groups. However, patients in the intervention group had lower IAP at the start of surgery and at all time points (p = 0.010) compared with controls. Conclusion: Preoperative respiratory physiotherapy had no impact on spirometry, but may have contributed to reduce IAP intraoperatively.
Descrição
Citação
RODRIGUES, Maria Amélia. Exercícios respiratórios no pré-operatório de abdominoplastia. 2018. 71 f. Tese (Doutorado em Cirurgia translacional) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2018.