open access

Vol 88, No 3 (2020)
ORIGINAL PAPERS
Published online: 2020-07-18
Submitted: 2019-09-25
Accepted: 2020-03-16
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A study on the effect of intraoperative continuous positive airway pressure (CPAP) on the postoperative pulmonary function in overweight patients undergoing lower limb, lower abdominal or vaginal surgeries under spinal anesthesia

Mamatha Munaf, Chitra Rajeswari, Manju Rajaram, Hemavathi Balachander
DOI: 10.5603/ARM.2020.0105
·
Pubmed: 32706100
·
Adv Respir Med 2020;88(3):176-182.

open access

Vol 88, No 3 (2020)
ORIGINAL PAPERS
Published online: 2020-07-18
Submitted: 2019-09-25
Accepted: 2020-03-16

Abstract

Introduction: Spinal anaesthesia, supine position and higher BMI are risk factors for pulmonary atelectasis. NIV, PEEP and CPAP are employed in ICU’s to treat atelectasis postoperatively. However, we wanted to investigate whether CPAP was protective against atelectasis when used intraoperatively, in high risk patients.
Material and methods: This study was a randomized controlled trial. Overweight patients, who were to undergo surgeries under spinal anesthesia were included in the study. After informed consent, 126 patients underwent preoperative pulmonary function tests (PFT: FEV1, FVC, PEFR). Following the onset of spinal anaesthesia patients were randomised into group E (n = 63, received CPAP) and control group, group C ( n =63, received nil intervention). Postoperative PFT was done at 20 minutes, 1 hour, 2 hours and 3 hours after surgery. Patients were followed up till discharge for pulmonary complications.
Results: We observed significant reduction in pulmonary function (FEV1, FVC and PEFR) postoperatively compared to base-line. CPAP group had better pulmonary function when compared to control group, the difference being significant 20 minu-tes after the surgery(p < 0.05). No postoperative pulmonary complication was reported among the 126 patients studied. Conclusion: Intraoperative use of CPAP in overweight patients undergoing surgeries under spinal anaesthesia could be beneficial in improving pulmonary function in the immediate post-operative period.

Abstract

Introduction: Spinal anaesthesia, supine position and higher BMI are risk factors for pulmonary atelectasis. NIV, PEEP and CPAP are employed in ICU’s to treat atelectasis postoperatively. However, we wanted to investigate whether CPAP was protective against atelectasis when used intraoperatively, in high risk patients.
Material and methods: This study was a randomized controlled trial. Overweight patients, who were to undergo surgeries under spinal anesthesia were included in the study. After informed consent, 126 patients underwent preoperative pulmonary function tests (PFT: FEV1, FVC, PEFR). Following the onset of spinal anaesthesia patients were randomised into group E (n = 63, received CPAP) and control group, group C ( n =63, received nil intervention). Postoperative PFT was done at 20 minutes, 1 hour, 2 hours and 3 hours after surgery. Patients were followed up till discharge for pulmonary complications.
Results: We observed significant reduction in pulmonary function (FEV1, FVC and PEFR) postoperatively compared to base-line. CPAP group had better pulmonary function when compared to control group, the difference being significant 20 minu-tes after the surgery(p < 0.05). No postoperative pulmonary complication was reported among the 126 patients studied. Conclusion: Intraoperative use of CPAP in overweight patients undergoing surgeries under spinal anaesthesia could be beneficial in improving pulmonary function in the immediate post-operative period.

Get Citation

Keywords

intraoperative CPAP; spinal anesthesia; overweight; pulmonary function

About this article
Title

A study on the effect of intraoperative continuous positive airway pressure (CPAP) on the postoperative pulmonary function in overweight patients undergoing lower limb, lower abdominal or vaginal surgeries under spinal anesthesia

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 3 (2020)

Pages

176-182

Published online

2020-07-18

DOI

10.5603/ARM.2020.0105

Pubmed

32706100

Bibliographic record

Adv Respir Med 2020;88(3):176-182.

Keywords

intraoperative CPAP
spinal anesthesia
overweight
pulmonary function

Authors

Mamatha Munaf
Chitra Rajeswari
Manju Rajaram
Hemavathi Balachander

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