The purpose of this study was to evaluate the circulatory and respiratory effects of extra early postoperative mobilization after PD.
A group of patients 122 scheduled to undergo open PD and post-operative care in ICU accepted to participate in study. Of those patients, 42 dropped out because of: 21 no or other surgery performed, 18 logistic reasons (arrival night, not extubated, reoperation for bleeding, left-out parameters), 1 declined post-operative participation, 2 declined mobilization in the evening due the pain. Of the remaining 80 patients 40 had been randomised to intervention group (mobilized out of bed 3 hours after arrival at post-operative department in the evening on the day of surgery and 60 degree head of bed elevation when resting in bed) and 40 to control group (mobilized out of bed the day after surgery and 30 degree head of bed elevation when resting in bed according to current practice). Outcome variables include e.g. noradrenaline (NA), postoperative length of stay (PLOS) in ICU and feasibility. The groups were comparable at baseline. Current results were based on included patients. Inclusion criteria was normal surgery course; 6–8 hours.
All patients in the treatment group were mobilized to sitting on side of bed (SOSOB) on the day of surgery. Time spent SOSOB was 6 minutes, median (2-20). Twenty-four of the patients also stood up 1 minute, median (0.08-5). The reasons for terminating the mobilization were low blood pressure (n=11), dizziness (n=4), nausea (n=5), vomiting (n=1), pain (n=5), tiredness (n=3), concern (n=1), leg weakness (n=2) and confusion (n=1). The duration of noradrenaline was significantly shorter in the treatment group (10 ± 12.7 vs 8 ± 8.7 hours). Post-operative length of stay was shorter in the treatment group (23 ± 10.9 vs 21 ± 5.2).
The results from this study indicate that patients undergoing open pancreatic surgery can be mobilized to SOSOB on the day of surgery but only for short periods of time and negative side effects are common. However, mobilization seems to have an impact on postoperatively use of NA and PLOS in the post-operative ICU.
This study is the first to evaluate the effect of extra early mobilization against a non-mobilized group. Through the knowledge of extra early mobilization after pancreatic surgery, post-operative care can be streamlined. Extra early mobilization may shorten time in postoperative care as well as reduce physical reactions and postoperative lung complicationes.
Carcinoma
Pancretaic
