Role of spirometry for preoperative evaluation of stable COPD patients before elective laparoscopic cholecystectomy

Abstract

Introduction: Postoperative pulmonary complications (PPC) are the main source of postoperative morbidity and mortality. Chronic Obstructive pulmonary Disease (COPD) patients are at 3 times more risk for the development of PPCs. Spirometry is commonly done as a part of preoperative evaluation. Our objective is to assess role of spirometry to predict PPCs in patients with stable COPD following laparoscopic Cholecystectomy. Material and Methods: This is a prospective observational study at a tertiary care centre. The study was approved by institutional ethics committee. 134 stable COPD patients posted for elective laparoscopic cholecystectomy under combined general epidural anaesthesia were included. Detailed clinical history was taken, physical examination was done, quality of life was assessed by COPD Assessment Test (CAT) score, chest X-ray, ABG, ECG, 2 D Echo, Spirometry, 6 minute walk test (6MWT) were done. Patients were followed up till discharge. Data of was analyzed by SPSS 11. Results: Out of 134 patients 112 (83.6%) were males and 22 (16.4%) were females. All were of more than 40yrs. All patients had CAT score > 10. 68 males and 16 females had FEV1 (Forced expiratory volume in 1 second) Conclusion: In patients with stable COPD of known severity, preoperative spirometry may not provide additional information in predicting PPC. Routine spirometry and arterial blood gases are not required for preoperative pulmonary evaluation in patients with stable COPD prior to laparoscopic cholecystectomy. Keywords: Preoperative; Spirometry; Pulmonary disease; Chronic obstructive; Postoperative complications.