Abstract
Changes in pulmonary function commonly occur after general surgery. The aims were to evaluate vital capacity, tidal volume and respiratory frequency among patients undergoing elective craniotomy and to determine possible correlations of these parameters with surgery duration and etiology for neurosurgery. Prospective, open study at a tertiary university hospital. Twenty-six patients underwent elective craniotomy for aneurysm clipping (11) or tumor resection (15). Vital capacity (VC), tidal volume (TV), minute volume (VE) and respiratory rate were determined before the operation and on the first to fourth postoperative days. There were significant decreases of 25% in VC, 22% in TV and 12% in VE (p < 0.05) and no significant increase in respiratory frequency (5%) on the first postoperative day. VE returned to baseline on the second postoperative day and TV on the third postoperative day, while VC was 8% lower on the fourth postoperative day, compared with before the operation (p < 0.05). VC reduction was significantly greater in patients undergoing aneurysm clipping (43%) than in patients undergoing tumor resection (14%) when surgery duration was more than four hours (p < 0.05), with no significant change when surgery duration was less than four hours. Reductions in VC, TV and VE were observed during the postoperative period in patients undergoing aneurysm clipping or tumor resection. The reductions in VC and TV were greater in patients undergoing craniotomy due to aneurysm and with longer surgery duration.
Highlights
Changes in pulmonary function commonly occur after general surgery.[1,2,3,4,5,6,7] These changes include decreased lung volume ranging from 25% to 60%,8 decreased tidal volume (TV), increased respiratory frequency,[9] gas exchange changes with decreased partial oxygen pressure[10,11] and decreased mucociliary clearance.[9]
VE returned to baseline on the second postoperative day and TV on the third postoperative day, while Vital capacity (VC) was 8% lower on the fourth postoperative day, compared with before the operation (p < 0.05)
VC reduction was significantly greater in patients undergoing aneurysm clipping (43%) than in patients undergoing tumor resection (14%) when surgery duration was more than four hours (p < 0.05), with no significant change when surgery duration was less than four hours
Summary
Changes in pulmonary function commonly occur after general surgery.[1,2,3,4,5,6,7] These changes include decreased lung volume ranging from 25% to 60%,8 decreased tidal volume (TV), increased respiratory frequency,[9] gas exchange changes with decreased partial oxygen pressure[10,11] and decreased mucociliary clearance.[9]. It is commonly said that surgery that does not involve incision of the abdominal or thoracic cavities has fewer effects on postoperative pulmonary function, with lower incidence of pulmonary complications.[2,9,15] As far as we know, there are no studies reporting on postoperative lung volume follow-up among patients who underwent craniotomy
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