incentive spirometry and upper abdominal laparoscopic surgery

Conditions: Cholecystitis; Perforated Duodenal Ulcer; Diaphragmatic Hernia; Benign Pancreas Tumor; Malignant Pancreatic Neoplasm; Splenic Infarction; Splenomegaly; Choledocholithiasis; Hiatal Hernia

Summary: to compare the effects of volume-oriented versus flow-oriented incentive spirometry on pulmonary function tests and functional capacity in patients of upper abdominal laparoscopic surgery. previous studies were designed to target only spirometer without focusing on its different types and their effects. this study covers the research gap and therefore is designed to observe effects of different types of spirometer on pulmonary function of patients undergoing upper abdominal laparoscopic surgery.

the volume oriented incentive spirometer enables the patient to inhale air through a mouthpiece and corrugated tubing which is attached to a plastic bellows. the volume of air displaced is indicated on a scale located on the device enclosure. after the patient has achieved the maximum volume, the individual is instructed to hold this volume constant for 3 to 5 seconds. studies suggest a physiologically significant difference in the effect of the flow- and volume-oriented incentive spirometer. flow-oriented devices enforce more work of breathing and increase muscular activity of the upper chest. volume-oriented devices enforce less work of breathing and improve diaphragmatic activity. research was carried out a study on two experimental groups of patients in order to evaluate the effects of aerobic exercise training and incentive spirometry in controlling pulmonary complications following laparoscopic cholecystectomy, results indicated a significant reduction in heart rate, oxygen saturation of hemoglobin (sao2), and inspiratory capacity for both groups. the researchers concluded that aerobic exercise and incentive spirometry were beneficial in reducing the postoperative pulmonary complications after laparoscopic cholecystectomy. another study observed the comparative study on the effect of preoperative and postoperative incentive spirometry on the pulmonary function of fifty patients who had undergone laparoscopic cholecystectomy. the authors concluded that pulmonary function is well-preserved with preoperative than postoperative incentive spirometry. another study observed that the volume incentive spirometry resulted in early recovery of both pulmonary function and diaphragm movement in patients who undergone laparoscopic abdominal surgery.

Eligibility criteria:
inclusion criteria: * patient with upper abdominal surgery (laparoscopy) exclusion criteria: * patients who had undergone open abdominal surgery and laparoscopic obstetrics and gynecological surgery. * patients with unstable hemodynamic parameters (arterial pressure\<100 mmhg systolic and \<60 mmhg for diastolic and mean arterial pressure (map) \<80mmhg. * patients with postoperative complications requiring mechanical ventilation. * uncooperative patients or patients unable to understand or to use the device properly * recent history of lower extremity fracture

Keywords: flow oriented incentive spirometry volume oriented incentive spirometry digital spirometer six minute walk test forced vital capacity (fvc) forced expiratory volume in the first second (fev1) upper abdominal laparoscopy