Effects of mobilization within the first 4 h following anatomical lung resection with thoracotomy.

Abstract

Thoracic incisions are very painful and complicated incisions. Many analgesic drugs including opioids are used to relieve pain in patients. We hypothesized that early mobilization and patient-centered strategy after lung resection reduce the incidence of perioperative complications and postoperative pain. We conducted a retrospective study on patients who underwent lung resection via thoracotomy and were mobilized in the first 4h postoperatively. Mobilization was defined as standing and walking at least 100m from the bed. If orthostatic hypotension occurred, mobilization was postponed for 30min. Analgesic treatment needs, walking distance, co-morbidity, hospitalization, postoperative complications within 30 days, and drainage and discharge times of patients were analyzed. The lobectomy with thoracotomy was performed in 48 patients. Thirty-six patients were male. The rate of additional systemic diseases was 58.3%. Forty patients walked in the first 3 h postoperatively. The mean walking distance was 140 ± 38.5m. The rate of orthostatic hypotension was 8.3%. The routine analgesic treatment included intravenous paracetamol 3g and dexketoprofen 100mg daily. In this study, 18% of patients received narcotic analgesics. Thromboembolic event and arrhythmia did not develop in any patient. The most common complication was prolonged air leaks (18.8%). Mobilization within the first 4h following anatomical lung resection is feasible and safe. Early mobilization provided pain relief after lung surgery and reduced the use of narcotic analgesics and cardiovascular complications. The article is the first study about walking in first hours after pulmonary lobectomy with thoracotomy in the thoracic surgery literature.