Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control

Abstract

Introduction: Although the methods used in thoracic surgery have been developing rapidly over the last five decades, postoperative pulmonary complications are seen in this field more than in other surgical branches. We aimed at comparing the acute effects of incentive spirometry (IS) and breathing retraining exercises by a respiratory physiotherapist or experienced physiotherapist.

Methods: Patients were randomized into two groups as spirometry and physiotherapist. Combined respiratory exercises were implemented through IS inspirometry group and by a physiotherapist in physiotherapist group. Blood gas, respiratory function tests, survey results of the Burford pain thermometer, discharge days, and cost analyses of both groups were examined just before the beginning of physiotherapy and on the 3^rd day of therapy.

Results: There were no statistical difference in first and last values of pH and PCO₂ and also there were no difference between groups (P > 0.05). Forced expiratory volume one second (FEV1) values are statistically increased compared to basal levels in both groups and mean difference in FEV1 values was statistically increased in physiotherapist group compared to spirometry group (P < 0.001). Forced vital capacity (FVC), PO₂ and SaO₂ values are statistically increased compared to basal levels in both groups but mean difference in FVC values was not statistically different between groups (P > 0.05). Cost analysis was not statistically different, mean hospitalization day and mean pain score were statistically decreased in physiotherapist group.

Conclusions: Based on the outcome of this study, respiratory physiotherapy methods carried out by a respiratory physiotherapist are more effective in acute cardiothoracic conditions after thoracotomy compared to IS by patients.

Keywords: Incentive spirometry, postoperative complications, respiratory physiotherapy