Summary
A study was undertaken to assess the role of post-operative pain in reducing Functional Residual Capacity (FRC) and Vital Capacity (VC). The efficacy of post-operative epidural analgesia in reversing these changes was measured in eight subjects after upper abdominal operations.
With pain, FRC and VC were 78 per cent and 37 per cent of control respectively. Following epidural analgesia, the values were 84 per cent and 55 per cent. These figures indicate the pain component in the post-operative reduction of these two lung capacities. This partial restoration may be of value in the prevention of post-operative pulmonary complications by avoiding closure of small airways during tidal breathing and by increasing the effectiveness of deep breathing and coughing in the removal of secretions and the reversal of atelectasis.
RéSUMé
Les auteurs ont entrepris une étude pour déterminer le rôle de la douleur dans la diminution de la Capacité Residuelle Fonctionnelle (CRF) et la Capacité Vitale (CV) dans la période postopératoire. Cela ainsi que l’efficacité de l’analgesie péridurale postopératoire pour rétablir les valeurs de ces deux capacités vers la valeur de contrôle fut determiné chez huit malades ayant subi des interventions intra-abdominales majeures. Les deux capacités étaient de 78 pour cent et 37 pour cent CRF et CV respectivement pendant la douleur; suivant l’analgesie peridurale ces deux capacités étaient à 84 pour cent et 55 pour cent. La différence indique la composante “douleur” dans la réduction universellement observée dans ces deux fonctions pulmonaires. Cette restoration incomplète pourrait quand même être utile dans la prévention des complications pulmonaires durant la phase postopératoire. Ceci ce ferait en empêchant la fermeture prématurée des petites voies aériennes pendant la ventilation normale et aussi en augmentant l’efficacité des manœuvres habituelles pour dégager les secretions et re-ouvrir les alvéoles.
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Supported by M.R.C. (Canada) Grant #MA-2598.
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Wahba, W.M., Don, H.F. & Craig, D.B. Post-operative epidural analgesia: Effects on lung volumes. Canad. Anaesth. Soc. J. 22, 519–527 (1975). https://doi.org/10.1007/BF03004868
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DOI: https://doi.org/10.1007/BF03004868