Postoperative Fatigue Research Articles

Effect of progressive muscle relaxation on postoperative pain, fatigue, and vital signs in patients with head and neck cancers: A randomized controlled trial

ObjectiveSurgery for head and neck cancers are associated with significant preoperative stress. We investigated the effects of progressive muscle relaxation (PMR) on postoperative pain, fatigue, and vital signs in patients with head and neck cancers. MethodsAll patients were hospitalized and randomly assigned to intervention or usual care groups. A generalized estimating equation was used to evaluate the PMR effects on pain and symptoms across the preoperative day to postoperative day 10. ResultsThe PMR group displayed significantly lower overall pain and muscle tightness than control group along with the timeline of multiple measurements (p < 0.01). PMR significantly reduces sleep disturbances and levels of fatigue, anxiety, and depression compared with the control group with time trend (p < 0.01). PMR also lowered the respiratory rates and diastolic blood pressure (p < 0.01). ConclusionsPMR can reduce sleep disturbances and levels of pain, fatigue, muscle tightness, anxiety, and depression in patients with head and neck cancer undergoing major surgeries. Future study should focus on improving the effectiveness of the exercise and standardization of the application. Practical implicationsprogressive muscle relaxation help relieve discomforts in patients with head and neck cancers with minimal costs and efforts.

Effect of Exercise Training on Quality of Life after Colorectal and Lung Cancer Surgery: A Meta-Analysis.

Simple SummarySurgery is the treatment modality associated with better long-term survival in patients diagnosed with lung cancer and colorectal cancer. However, as a result of surgery, patients experience a substantial decline in health-related quality of life (HRQoL) and increased fatigue symptoms. The purpose of this systematic review was to investigate the effect of pre- and/or postoperative exercise training on HRQoL and fatigue after surgical resection for lung and colorectal cancer. Our results showed that exercise training interventions improve the physical domain of HRQoL and reduce fatigue levels after lung cancer surgery, supporting its use to optimize patients’ recovery. No benefits were found on HRQoL and fatigue after colorectal cancer surgery.Surgical treatment affects health-related quality of life (HRQoL) and increases fatigue symptoms in patients with lung cancer (LC) and colorectal cancer (CRC). We aimed to systematically review the effect of exercise training on HRQoL and fatigue after LC and CRC surgery. Randomized controlled trials published before 21 March 2021, were searched in PubMed, Scopus, Web of Science, SPORTDiscus and PEDro. Eligible trials compared the effect of exercise interventions initiated preoperatively or in the first 3 months after surgery versus usual care on postoperative HRQoL and fatigue. Standardized mean differences (SMD) were pooled using random-effects models. Twelve studies with a total of 777 patients were included. In LC patients (10 studies, n = 651), exercise training in general led to a moderate improvement in the physical domain of HRQoL (0.68: 95% CI: [0.47; 0.89]) and a small reduction in fatigue levels after surgery (SMD = 0.28: 95% CI: [0.02; 0.53]), while no effects were found in other HRQoL domains. In CRC (two studies, n = 126), exercise training showed no effects on HRQoL and fatigue after surgery. Exercise training is an effective intervention to improve physical function and fatigue after LC surgery. Further studies are necessary to clarify the effects of exercise on HRQoL and fatigue after CRC surgery.

Lymphovenous anastomoses with three-dimensional digital hybrid visualization: improving ergonomics for supermicrosurgery in lymphedema.

The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2–0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.

Roles of Exosomes and Exosomal MicroRNAs in Postoperative Sleep Disturbance

Postoperative sleep disturbance (PSD) often occurs in elderly patients after major surgery and exerts harmful effects on postoperative recovery. PSD may increase the incidence of postoperative fatigue, severe anxiety and depression, pain sensitivity, and cognitive dysfunction, which can cause or aggravate neurodegenerative diseases via amyloid aggregation and tau accumulation. Exosomes are important carriers that mediate the transfer of active substances and genetic information among cells. Recent evidence has shown that exosomes are involved in the pathogenesis of end-organ morbidity caused by sleep disorders via increasing amyloid plaque formation, transmitting tau protein, regulating neuroinflammation, and increasing blood–brain barrier permeability. Additionally, exosomes may be useful for delivering therapeutic genetic materials, such as microRNAs (miRNAs) and proteins, to exert neuroprotective effects and reduce cognitive impairment. However, the molecular mechanisms underlying this process remain to be fully elucidated. This review focuses on exosome-related pathways and the modulatory role of exosomal miRNAs on the pathogenesis of sleep disturbance and neurodegeneration. Moreover, we discuss the advantages of reducing neurotoxic proteins via exosomal intervention and miRNA regulation. Future research in exosome administration may offer new insights into PSD-related pathomechanisms and therapeutics.

Circulating brain injury biomarkers increase after endoscopic surgery for pituitary tumors

Pituitary tumors and subsequent treatment with endoscopic transsphenoidal surgery (ETSS) may cause injury to suprasellar structures, causing long-term fatigue and neurocognitive impairment. A method to quantify brain injury after ETSS is not available. In this prospective, exploratory study of patients undergoing ETSS for pituitary tumors, a novel approach to detect possible neuronal damage is presented. Plasma concentrations of brain injury biomarkers (glial fibrillary acidic protein [GFAP], tau, and neurofilament light [NFL]) were measured the day before surgery, immediately after surgery, at day 1 and 5, and at 6 and 12 months after surgery, using enzyme-linked immunosorbent assays. The association between the increase of biomarkers with preoperative tumor extension and postoperative patient-perceived fatigue was evaluated. Suprasellar tumor extension was assessed from MRI scans, and self-perceived fatigue was assessed using the Multidimensional Fatigue Inventory before and 6 months after surgery. Thirty-five patients were included in the analysis. Compared to baseline, GFAP showed a maximal increase at day 1 after surgery (p = 0.0005), tau peaked postoperatively on the day of surgery (p = 0.019), and NFL reached its maximum at day 5 after surgery (p < 0.0001). The increase in GFAP correlated with preoperative chiasmal compression (p = 0.020). The increase in tau was correlated with preoperative chiasmal (p = 0.011) and hypothalamus compression (p = 0.016), and fatigue score 6 months after surgery (p = 0.016). In conclusion, the concentrations of brain injury biomarkers in blood increased after ETSS for pituitary tumors. The results indicate that postoperative plasma GFAP and tau might reflect astroglial and neuronal damage after ETSS.

Effect of preoperative oral liquid carbohydrate intake on blood glucose, fasting-thirst, and fatigue levels: a randomized controlled study

BackgroundThis study aimed to analyze the effects of preoperative oral intake of liquid carbohydrate on postoperative blood glucose, fasting-thirst, and fatigue levels in patients undergoing arthroscopic surgery. MethodsThis randomized controlled clinical trial enrolled 82 patients, who were scheduled to undergo arthroscopic surgery, and divided them into two groups: (1) those who consumed a carbohydrate-rich drink, and (2) those not consuming anything after midnight. Pre- and postoperative fasting-thirst (visual analog scale) and blood glucose levels were measured. Likewise, the Brief Fatigue Inventory was applied to patients 24 hours after surgery. ResultsThe mean blood glucose levels in the first postoperative hour were 90.90 ± 13.56 mg.dL-1 and 107.00 ± 15.84 mg.dL-1 in the intervention group and control group, respectively (p < 0.001). The postoperative mean thirst scores were 4.70 ± 1.59 and 6.36 ± 2.07 in the intervention group and control group, respectively (p < 0.001). Their corresponding postoperative mean fasting scores were 5.54 ± 1.76 and 5.86 ± 1.79 (p > 0.05) and the mean fatigue levels in the 24th postoperative hour were 4.80 ± 2.13 and 5.48 ± 1.46, respectively (p > 0.05). ConclusionsOral intake of liquid carbohydrate before spinal anesthesia was found to have positive effects on patients’ postoperative blood glucose and thirst levels.

Receptive music therapy: An effective means to enhance well-being in patients undergoing cesarean section and hysterectomy and their operating team

Background: Cesarean section and hysterectomy are important life-changing gynecologic surgeries which can potentially influence physical and psychological well-being. There is a need to address the psychological aspects of care through nonpharmacological measures. Multilevel and multidimensional effects of music therapy have been shown to have potential benefits in many clinical conditions in this regard. Objectives: The aim of this study was to explore the effects of receptive music therapy on perioperative anxiety and hemodynamic profile in patients undergoing hysterectomy and cesarean section and to analyze perceptions and experiences of surgical team involved in their care. Materials and Methods: A total of 141 patients undergoing elective cesarean section/hysterectomy were enrolled. Physiological and psychological parameters such as pulse, respiratory rate, blood pressure, pain, fatigue, overall psychological well-being measured peri-operatively were compared between intervention group (n = 65) and control group (n = 76). Subjective well-being was assessed using the Visual Analog Scale for perioperative anxiety, postoperative fatigue was assessed using a 5-grade Linear Analog Scale, overall well-being was assessed using a 5-grade Linear Analog Scale. Experiences and perceptions of health-care team operating upon these patients about deliverance and effects of receptive music were recorded with the help of semi-quantitative questionnaire. Results: There was a statistically significant reduction in perioperative anxiety in patients receiving music therapy (P 0.05). Health-care professionals reported positive influence of listening to music during the surgery in form of reduction of their stress and increase in comfort. Conclusion: Receptive music therapy reduces perioperative anxiety in patients undergoing hysterectomy and cesarean section and has de-stressing and refreshing effects on operating team.

The Effect of General Anaesthesia on Circadian Rhythms in Behaviour and Clock Gene Expression of Drosophila melanogaster.

General anaesthesia (GA) is implicated as a cause of postoperative sleep disruption and fatigue with part of the disturbance being attributed to a shift of the circadian clock. In this study, Drosophila melanogaster was used as a model to determine how Isoflurane affects the circadian clock at the behavioural and molecular levels. We measured the response of the clock at both of these levels caused by different durations and different concentrations of Isoflurane at circadian time 4 (CT4). Once characterized, we held the duration and concentration constants (at 2% in air for 6 h) and calculated the phase responses over the entire circadian cycle in both activity and period expression. Phase advances in behaviour were observed during the subjective day, whereas phase delays were associated with subjective night time GA interventions. The corresponding pattern of gene expression preceded the behavioural pattern by approximately four hours. We discuss the implications of this effect for clinical and research practice.

Postoperative fatigue after day surgery: prevalence and risk factors. A prospective observational study.

Postoperative fatigue (POF) is a major cause of rehabilitation failure after surgery. POF is a complication that could negatively affect outpatients but to date no study has specifically investigated POF at home after day surgery. The objective of this study was to assess early and late POF and risk factors for POF after day surgery. This prospective single center observational study was conducted from October 2015 to January 2016. All patients scheduled for day surgery under general or regional anesthesia were assessed for eligibility. The primary endpoint was the prevalence of early POF (Day 1), defined by a VAS measurement of fatigue greater than three (on a scale of 0 to 10). Secondary endpoints were the prevalence of late POF (Day 7), the prevalence of severe POF (VAS> 6) at D1 and D7 and risk factors for preoperative fatigue, and for early and late POF. Among 348 patients, the prevalence of early and late POF was 37% (95% CI: 32-42) and 16% (95% CI: 12.1-19.9), respectively. The prevalence of severe POF was 9% at D1 and 3% at D7. The main risk factor for early POF was postoperative pain (P<0.01). This work suggests that early and late POF are common after day surgery but that severe POF is rare. Postoperative pain is the main risk factors for the early POF. The optimized management of postoperative pain could probably decrease the prevalence of POF after day surgery.

Patient experience of health and care when undergoing colorectal surgery within the ERAS program

BackgroundSeveral studies show that the enhanced recovery after surgery (ERAS) program reduces complications postoperatively and leads to faster recovery and shorter hospital stays. However, little is known about patients’ self-reported health in an enhanced recovery context. The aim of this study was firstly to describe patient experiences of health within the concept of ERAS after colorectal (CR) surgery during a hospital stay and within 2 weeks of discharge. Secondly, to explore whether the ASA classification/co-morbidity, sex, and surgical method affect the patient’s experience of health.MethodsData were collected through the ERAS-HEALTH questionnaire, including two open-ended questions, and through telephone interviews postoperatively. Qualitative and quantitative analysis was used. Patients undergoing CR surgery (n = 80) were included from October 2016 to June 2018.ResultsThe patients had mainly positive experiences of their hospital stay as well as most of them felt comfortable coming home. However, experienced state of health is affected by factors like surgical method and co-morbidity. Improvements were desired concerning information, food/food intake, pain management, and environment. At home, the patients experienced a lack of information about food/food intake and ostomy care. Decreased appetite and difficulties with micturition were also described. The most troublesome symptom was postoperative fatigue (POF). Analysis of the ERAS-HEALTH questionnaire showed that patients with higher co-morbidity and those who underwent open surgery have a significantly worse experience of their health compared with patients who underwent laparoscopy. However, it seems that the surgical method affects postoperative health to a greater extent than co-morbidity.ConclusionsThe patients reported many positive aspects and challenges when being cared for within the ERAS program. However, several improvements are needed to satisfy patient wishes regarding their care both in hospital and at home. Laparoscopic surgery affects patient state of health positively in several respects compared with open surgery.

SUN-416 Fatigue and Quality of Life Among Thyroid Cancer Survivors

BACKGROUND Fatigue among thyroid cancer survivors is an important issue that needs to be appreciated and managed appropriately. Although several studies have reported potential factors that might be related to postoperative fatigue, the associations have yet to be inconclusive. The purpose of the present study was to estimate the prevalence of clinical fatigue in patients with papillary thyroid carcinoma and to reveal predictive factors, including their quality of life. METHODS A cross-sectional survey was conducted on patients with papillary thyroid carcinoma. Patients who underwent non-curative surgery, or those with recurrent or metastatic PTC, or those with other malignancies were excluded. The primary outcome was fatigue measured by the Cancer Fatigue Scale (CFS), and the secondary outcome was quality of life (QoL) quantified using the SF-36 v2. The following explanatory variables were collected; gender, age, employment status, marital status, co-morbidities, time since initial surgery, types of surgery, replacement of thyroid hormone, use of radioactive iodine, and the level of thyrotropin. The prevalence of clinical fatigue was estimated with the cut-off value of 18/19 of the CFS score. Correlations between the CFS score and the explanatory variables were examined using uni-variable analyses as well as multi-variable analysis. RESULTS Three hundred twenty-one patients participated in the survey. Of them, 258 respondents (80%) were female. The median age was 58 years, and the median time from initial surgery was 6.4 years. The mean and the standard deviation of the CFS score were 17.9 and 9.3, respectively (range: 0-48). The prevalence of clinical fatigue was 42% [95%CI: 36-47%]. Among the variables explored, having a job and scores of the mental component summary, the physical component summary, and the role/social component summary of the SF-36 were inversely associated with the CFS score in both uni- and multivariable analyses. CONCLUSION Postoperative fatigue was common in thyroid cancer survivors. Patients with a job and better QoL, in particular, those with good mental health, maybe at low-risk of developing the burden.

Risk factors and the utility of three different kinds of prediction models for postoperative fatigue after gastrointestinal tumor surgery

Postoperative fatigue (POF) is a common complication after gastrointestinal tumor surgery, and it also brings negative effect on prognosis and life quality. However, there are no prediction models for POF, and studies of risk factors are not comprehensive. Therefore, the aim of this study is to investigate the risk factors and pick out the best prediction model for POF and to validate it. A prospective study was conducted for patients undergoing elective gastrointestinal tumor surgery. Physiological, psychological, and socioeconomic factors were collected. Logistic regression, back-propagation artificial neural networks (BP-ANNs), and classification and regression tree (CART) were constructed and compared. A total of 598 patients consisting of 463 derivation sample and 135 validation sample were included. The incidence of POF in derivation sample, validation sample, and total were 58.3%, 57.0%, and 58.7%, respectively. Logistic regression results showed age, higher degree of education, lower personal monthly income, advanced cancer, hypoproteinemia, preoperative anxiety or depression, and limited social support were risk factors for POF. Receiver operating characteristic curve (ROC) and performance indices were used to test three models. BP-ANN was the best by the comparison of models, and its strong predictive performance was also validated. More attention should be paid on specific patients after gastrointestinal tumor surgery. BP-ANN is a powerful mathematical tool that could predict POF exactly. It may be used as a noninvasive screening tool to guide clinicians for early identification of high-risk patients and grading interventions.

Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty.

ObjectiveTo evaluate the efficacy and safety of combined use of tranexamic acid (TXA) and dexamethasone (DEX) for anti‐inflammatory and clinical outcomes after total hip arthroplasty (THA).MethodsA total of 100 patients were included in this randomized, controlled study. Patients in the TXA + DEX group were administered TXA at a dose of 15 mg/kg, which was repeated 3 h after THA, and received 20 mg DEX. In contrast, patients in the TXA group were administered TXA at a dose of 15 mg/kg, which was repeated at 3 h postoperatively. C‐reactive protein (CRP), interleukin‐6 (IL‐6) and pain levels, incidence of postoperative nausea and vomiting (PONV), total blood loss and transfusion rates, postoperative fatigue, range of motion (ROM), length of hospital stay (LOS), analgesic rescue and antiemetic rescue consumption, and complications were compared in both groups.ResultsThe CRP and IL‐6 levels were lower in the TXA + DEX group than in the TXA group (all P < 0.001) at 24 h, 48 h, and 72 h postoperatively. Patients in the TXA + DEX group had lower pain scores at rest and walking at 24 h postoperatively (all P < 0.001). In the TXA + DEX group, the incidence of PONV was lower (P = 0.005), postoperative fatigue (P < 0.001) was reduced, and analgesia and antiemetic rescue consumption were also reduced. The total blood loss, transfusion rate, LOS and hip ROM were similar in the two groups. There was no thrombosis, infection, or gastrointestinal bleeding in either group.ConclusionCompared to TXA alone, the combination of TXA + DEX can reduce postoperative inflammatory response, relieve pain, and reduce PONV and fatigue, without increasing the risk of complications. Therefore, the present study suggested that the combination of TXA + DEX is an effective and safe accelerated rehabilitation strategy for patients receiving primary unilateral THA.

Preoperative, single, high-dose glucocorticoid administration in abdominal wall reconstruction: A randomized, double-blinded clinical trial

BackgroundAlthough preoperative administration of high-dose glucocorticoid may lead to improved recovery after operative procedures, this regimen has not been examined in patients undergoing abdominal wall reconstruction for repair of large ventral hernias. The aim of the current trial was to examine the effects of preoperative, single high-dose glucocorticoid on recovery after abdominal wall reconstruction. MethodForty patients undergoing abdominal wall reconstruction for repair of ventral incisional hernias with a horizontal fascial defect >10 cm were randomized to intravenous administration of either 125 mg methylprednisolone or placebo at the induction of anesthesia. The primary endpoint was pain in the supine position as assessed by a numeric rating scale of 0 to 10 at rest at 8 am on the first postoperative day. Secondary outcomes included postoperative pain during activity, nausea, fatigue, inflammatory response (measured by plasma levels of C-reactive protein), duration of stay, and 30-day complications or readmissions. ResultsThere was no difference in pain at rest on the first postoperative day (methylprednisolone mean 1.7 vs placebo 2.2, P > .95), whereas patients in the methylprednisolone group reported less pain during activity (mean 3.0 vs 5.0; P = .011) and during coughing (3.4 vs 5.9; P = .010). There were no differences between the 2 groups regarding postoperative fatigue or nausea. Postoperative levels of C-reactive protein were less in the methylprednisolone group (P = .039). ConclusionA single-shot, high-dose methylprednisolone before abdominal wall reconstruction for a large incisional hernia decreased early postoperative pain and attenuated the inflammatory response.

Perioperative fatigue in patients with diffuse glioma

PurposeFew studies have assessed fatigue in relation to glioma surgery. The purpose of this study was to explore the prevalence of pre- and postoperative high fatigue, perioperative changes, and factors associated with pre- and postoperative high fatigue in patients undergoing primary surgery for diffuse glioma.MethodsA total of 112 adult patients were prospectively included. Patient-reported fatigue was assessed before and one month after surgery using the cancer-specific European Organization for Research and Treatment of Cancer questionnaire fatigue subscale. The scores were dichotomized as high fatigue (≥ 39) or low fatigue (< 39). A change in score of ≥ 10 was considered as a clinically significant change. Factors associated with pre- and postoperative high fatigue were explored in multivariable regression analyses.ResultsHigh fatigue was reported by 45% of the patients preoperatively and by 42% of the patients postoperatively. Female gender and low Karnofsky Performance Status (KPS) were associated with preoperative high fatigue, while postoperative complications, low KPS and low-grade histopathology were associated with postoperative high fatigue. In total 35/92 (38%) patients reported a clinically significant improvement of fatigue scores after surgery, 36/92 (39%) patients reported a clinically significant worsening of fatigue scores after surgery, and 21/92 (23%) patients reported no clinically significant change in fatigue scores after surgery. Patients with low-grade gliomas more often reported low fatigue before surgery and high fatigue after surgery, while patients with high-grade gliomas more often reported high fatigue before surgery and low fatigue after surgery.ConclusionsOur findings indicate that fatigue is a common symptom in patients with diffuse glioma, both pre- and postoperatively. Perioperative changes were frequently seen. This is important knowledge when informing patients before and after surgery.

Closure of the fascial defect during laparoscopic umbilical hernia repair: a randomized clinical trial

The objective of the study was to analyse patient-reported outcome measures (PROMs), seroma formation, long-term recurrence and chronic pain after closure of the fascial defect in patients undergoing laparoscopic umbilical hernia mesh repair. This was a randomized double-blinded trial in patients undergoing elective laparoscopic umbilical hernia repair comparing sutured closure of the fascial defect before intraperitoneal onlay mesh (IPOM) repair with a no-closure IPOM repair. Postoperative pain, movement limitations, discomfort and fatigue were registered before surgery and on postoperative days 1-3, 7 and 30. Seroma formation, quality of life and cosmesis were assessed at day 30, and at 2 years of follow-up. Recurrence (clinical and reoperation) and chronic pain were assessed after 2 years. Eighty patients were randomized. Median defect sizes in closure and no-closure groups were 2·5 (range 1·5-4·0) and 2·5 (2·0-5·5)cm respectively (P=0·895). There were no significant differences in early and late postoperative pain or in any other early or late PROMs, except for early fatigue which was higher in the closure group (P=0·011). Seroma formation after 30 days was significantly reduced after closure (14 of 40; 35 (95 per cent c.i. 22 to 51) per cent) compared with no closure (22 of 38; 58 (42 to 72) per cent) (P=0·043). Cumulative recurrence after 2 years was lower in the closure group: 5 of 36 (7 (3 to 17) per cent) versus 12 of 37 (19 (10 to 33) per cent) for no closure (P=0·047). Closure of the fascial defect in laparoscopic umbilical hernia IPOM repair significantly reduced early seroma formation and long-term recurrence without inducing side-effects such as pain, or other early or late PROMs. Registration number: NCT01962480 ( https://www.clinicaltrials.gov).

Evaluation of the Value of Nursing Intervention Guidance in Controlling the Fatigue Level of Patients with Breast Cancer

To investigate the effect of the continuous nursing intervention model on postoperative fatigue levels and quality of life in breast cancer patients. A total of 112 patients with breast cancer who received radiotherapy and chemotherapy in the oncology department of our hospital from January 2018 to January 2020 were collected and randomly divided into the observation group (n=56) and the control group (n=56). The general clinical data of the two groups were comparable. Patients in the control group were instructed with conventional nursing interventions, while those in the observation group were given continuous nursing management in addition to conventional nursing care, and their mastery of nursing management health, quality of life and changes in cancer-related fatigue status were assessed by the selfadministered questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, and the revised piper fatigue scale, respectively. The results showed that only 35 (62.50 %) patients in the control group were completely compliance, 4 (7.14 %) were partially compliance, and 17 (30.36 %) were non-compliance, while 48 (85.71 %) were completely compliance, 6 (10.71%) were partially compliance, and 2 (3.58 %) were non-compliance in the observation group, the difference between the two groups was statistically significant (p<0.05). After nursing, the quality of life scores of patients in the control group and the observation group were significantly improved, and the revised piper fatigue scale scores decreased significantly, the quality of life of the patients and the cancer related fatigue in the observation group was more significantly improved than that in the control group, and the difference was statistically significant (p<0.05). In the nursing intervention of breast cancer patients, the continuous intervention model can improve the life and mental state of breast cancer patients significantly, to improve their quality of life, alleviate the symptoms of cancer-related fatigue, and promote the rehabilitation of breast cancer patients.

Predicting postoperative fatigue in surgically treated lung cancer patients in Norway: a longitudinal 5-month follow-up study

ObjectivesDespite the negative influence of fatigue on quality of life in patients who undergo lung cancer surgery, little is known about the possible predictors of postoperative fatigue. The aim of...

The combined effect of vitamin C and omega-3 polyunsaturated fatty acids on fatigue following coronary artery bypass graft surgery: a triple-blind clinical trial.

Background Fatigue is a common compliant among patients who undergo coronary artery bypass graft (CABG) surgery. This may affect patients' function in all aspects. A few studies have already assessed the influence of complementary therapies on minimizing fatigue. This study aimed to investigate the combined effect of vitamin C and omega-3 polyunsaturated fatty acids (n-3 PUFA) on fatigue following CABG surgery. Methods In this randomized, triple-blind placebo-controlled trial, 160 patients who already underwent CABG surgery were randomly assigned into an experimental or a control groups. Each group consisted of 80 patients. The experimental group was given both n-3 PUFA and vitamin C the day before surgery. They also received the same supplements in the first 5 days of operation. The control group received only placebo. Subjects in both groups responded to Multidimensional Fatigue Inventory (MFI-20) scale in the beginning, and at the end of the intervention as well as on the fifth day of the operation. Chi-square test and independent t-test were used for data analysis. Results The mean fatigue score in experimental and control groups came up to 62.01 ± 4.06 and 67.92 ± 4.95 (p<0.0001), respectively, which was greater than that of the values we had before intervention. The mean difference of fatigue score was 3.97 ± 3.49 and 9.56 ± 6.41 (p<0.0001) prior and following the intervention, correspondingly. Conclusion Combination of vitamin C and n-3 PUFA effectively reduces post-operative fatigue among patients who undergo CABG surgery.

Perioperative combined administration of tranexamic acid and dexamethasone in total knee arthroplasty-benefit versus harm?

Background:The purpose of this study was to investigate the benefits and harm of combined administration of tranexamic acid (TXA) and dexamethasone (Dexa) in total knee arthroplasty (TKA).Methods:A total of 88 consecutive patients undergoing TKA for knee osteoarthritis were stratified in 2 groups. All surgeries were performed under general anesthesia. Brief, patients in the TXA + Dexa group (n = 45) received 10 mg Dexa just after the anesthesia, and repeated at 24 hours after the surgery; and patients in the TXA group (n = 43) received 2 ml of normal saline solution at the same time. The measured outcomes were the C-reactive protein (CRP) and interleukin-6 (IL-6) from preoperatively to postoperatively, and postoperative nausea and vomiting (PONV), fatigue, range of motion (ROM), length of stay (LOS), and the analgesic and antiemetic rescue consumptionResults:The level of CRP and IL-6 in the TXA + Dexa group were lower than that in the TXA group at 24 hours (P < .001, P < .001), 48 hours (P < .001, P < .001), and 72 hours (P < .001, P < .001) after the surgery. The pain scores in the TXA + Dexa group were lower during walking at 24 hours (P < .001), 48 hours (P < .001), and 72 hours (P < .001) and at rest at 24 hours (P = .022) after the surgery. Patients in the TXA + Dexa group had a lower nausea score, the incidence of PONV, fatigue, and the analgesic and antiemetic rescue consumption, and had a greater ROM than that in the TXA group. No significant differences were found in LOS and complications.Conclusion:The combined administration of TXA + Dexa significantly reduced the level of postoperative CRP and IL-6, relieve postoperative pain, ameliorate the incidence of POVN, provide additional analgesic and antiemetic effects, reduce postoperative fatigue, and improve ROM, without increasing the risk of complications in primary TKA.