| Recovery of pulmonary functions according to the operative sites after general anesthesia. |
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Hyeon Tae Kim, Sang Moo Lee, Soo Taek Uh, Yeon Tae Chung, Yong Hoon Kim, Choon Sik Park |
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Depatment of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea |
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| Abstract |
Background
After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation /perfusion imbalance. and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients.
Methods
Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most.sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5.
Results
1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. PaCO2 was slightly elevated at postoperative one day 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pull110nary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia ia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1.
Conclusion
Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication |
| Key Words:
Postoperative hypoxemia, Diaphragm dysfunction, Pulmonary function test |
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