The Influence of Early Rehabilitation on Changes in the Range of Spinal and Thoracic Mobility in Patients after Thoracotomy Due to Lung Cancer Depending on Used Anaesthesia

Abstract

Introduction: To the best of our knowledge, no reports are available on the relationship between the technique of anaesthesia and the effects of rehabilitation. Objective: The aim of the study is to assess the effectiveness of early rehabilitation on changes in range of spinal and thoracic mobility with different pain control after thoracotomy due to lung cancer. Material and methods: The study involved 100 patients following lung lobe resection by open anterolateral thoracotomy. After the operation, participants were assigned to 2 groups depending on the use of additional anaesthesia. All participants received standardised post-operative physiotherapy. The range of mobility of the spine and chest, the verbal rating scale (VRS) and visual analogue scale (VAS) were measured before and on the 1st, 3rd and 7th day after surgery. Results: In the study, an increase was shown in measurements for patients from both groups undergoing the rehabilitation programme after surgery. Mobility was highly significant in the study group. However, the mobility of the chest decreased in both groups, and in subsequent measurements following physiotherapy, its range improved, although it did not reach the baseline level even on the 7th day after the procedure. Consequently, 1 week after surgery, the decrease in spinal mobility among the group with standard anaesthesia was 1.3 cm greater than in the group with additional anaesthesia (-1.5 vs. -0.2 cm). Pain changes were greater in the control group. Conclusions: 1. It may be concluded that the mobility of the thoracic spine after the procedure in decreased both groups, to later significantly improve for subsequent measurements in favour of patients with additional analgesia. 2. Respiratory mechanics of the chest and the level of pain, both measured by the VRS and VAS, systematically decreased in subsequent measurements after surgery among both groups, however, greater respiratory mobility was noted in the group of patients with additional analgesia. 3. It was demonstrated that the patients from the study group achieved optimal measurement values in relation to the control group, which were measured several times after the procedure, demonstrating a shorter and effective post-operative rehabilitation process.