Postoperative recovery optimization protocol associated with physiotherapeutic assistance of patients undergoing bariatric surgery
DOI:
https://doi.org/10.62827/fb.v25i1.2n91Keywords:
anesthesia; bariatric surgery; physiotherapy; obesity.Abstract
Objective: To analyze the Enhanced Recovery After Surgery (ERAS) protocol associated with physiotherapeutic assistance in the postoperative period of patients undergoing bariatric surgery. Methods: Data from the medical records of 190 patients, aged 18 years or older, of both sexes, who underwent bariatric surgery by videolaparoscopy, were included. For all patients, data were collected preoperatively, intraoperatively, and postoperatively. Results: There was a prevalence of female patients in the study (81,6% - n=155) and most patients had grade 3 obesity (46,8% - n= 89). 98,6% (n = 188) of the patients did not show ventilatory disorders in the spirometry test and 92,6% (n = 176) of the individuals had never smoked. Regarding comorbidities, Systemic Arterial Hypertension was present in 24% (n = 46) of patients, followed by Diabetes Mellitus 2 in 8% (n =15) of individuals. With regard to length of stay, most patients (45,8% - n= 87) remained hospitalized for 12 hours. Regarding postoperative changes, more than 90% (n=171) of patients did not show any changes during this period. There was a significant difference in the analyzed variables, with vital signs maintained at physiological levels. Conclusion: A low incidence of postoperative alterations can be observed with adequate hospitalization time. Vital signs remained within physiological levels, demonstrating the safety of the postoperative recovery optimization protocol associated with physiotherapeutic assistance in the postoperative period of patients undergoing bariatric surgery by videolaparoscopy.
References
Wang Y, Beydoun MA, Min J, Xue H, Kaminsky LA, Cheskin LJ. Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic. Int J Epidemiol. 2020 Jun 1;49(3):810-823. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394965/ DOI: 10.1093/ije/dyz273
Csige I, Ujvárosy D, Szabó Z, Lőrincz I, Paragh G, Harangi M, Somodi S. The Impact of Obesity on the Cardiovascular System. J Diabetes Res. 2018 Nov 4;2018:34073064; 2018:3407306. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247580/. DOI: 10.1155/2018/3407306
Arroyo-Johnson C, Mincey KD. Obesity Epidemiology Worldwide. Gastroenterol Clin North Am. 2016 Dec;45(4):571-579. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599163/. DOI: 10.1016/j.gtc.2016.07.012
Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: A systematic review and meta-analysis. PLoS Med. 2020 Jul 28;17(7):e1003206. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386646/. DOI: 10.1371/journal.pmed.1003206
Schetz M, De Jong A, Deane AM, Druml W, Hemelaar P, Pelosi P, Pickkers P, Reintam-Blaser A, Roberts J, Sakr Y, Jaber S. Obesity in the critically ill: a narrative review. Intensive Care Med. 2019 Jun;45(6):757-769. Disponível em: https://link.springer.com/article/10.1007/s00134-019-05594-1. DOI: 10.1007/s00134-019-05594-1
Helling TS, Willoughby TL, Maxfield DM, Ryan P. Determinants of the need for intensive care and prolonged mechanical ventilation in patients undergoing bariatric surgery. Obes Surg. 2004 Sep;14(8):1036-41. Disponível em: https://pubmed.ncbi.nlm.nih.gov/15479591/. DOI: 10.1381/0960892041975488
Pouwels S, Smeenk FW, Manschot L, Lascaris B, Nienhuijs S, Bouwman RA, Buise MP. Perioperative respiratory care in obese patients undergoing bariatric surgery: Implications for clinical practice. Respir Med. 2016 Aug;117:73Aug; 117:73-80. Disponível em: https://www.resmedjournal.com/article/S0954-6111(16)30128-7/fulltext. DOI: 10.1016/j.rmed.2016.06.004
Juvin P, Lavaut E, Dupont H, Lefevre P, Demetriou M, Dumoulin JL, Desmonts JM. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg. 2003 Aug;97(2):595-600. Disponível em: https://journals.lww.com/anesthesia-analgesia/fulltext/2003/08000/difficult_tracheal_intubation_is_more_common_in.53.aspx. DOI: 10.1213/01.ANE.0000072547.75928.B0000072547. 75928.B0
Baltieri L, Peixoto-Souza FS, Rasera-Junior I, Montebelo MIL, Costa D, Pazzionotto-Forti EM. Análise da prevalência de atelectasia em pacientes submetidos à cirurgia bariátrica. Brazilian Journal of Anesthesiology. 2016;66(6):577-582. Disponível em: https://www.sciencedirect.com/science/article/pii/S003470941500104X?via%3Dihub
Baltieri L, Santos LA, Peixoto-Souza FS, Rasera-Junior I, Montebelo MIL. Efeitos da pressão positiva nas vias aéreas no antes, durante e depois da cirurgia bariátrica: Estudo Randomizado e Cego. Revista Baiana de Saúde Pública. 2018;41(3):685-698. Disponível em: https://rbsp.sesab.ba.gov.br/index.php/rbsp/article/view/1304. DOI: https://doi.org/10.22278/2318-2660.2017.v41.n3.a1304
Pazzianotto-Forti EM, Baltieri L, Brigatto P, Costa CM, Rocha MRS, Rasera-junior I. Bilevel positive airway pressure in two moments after bariatric surgery. Revista da Associação Médica Brasileira. 2019 Oct 10;65(9). Disponível em: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S010442302019000901161. DOI: https://doi.org/10.1590/1806-9282.65.9.1161Doi: https://doi.org/10.1590/1806-9282.65.9.1161
Khorgami Z, Petrosky JA, Andalib A, Aminian A, Schauer PR, Brethauer SA. Fast track bariatric surgery: safety of discharge on the first postoperative day after bariatric surgery. Surgery For Obesity and Related Diseases. 2017;13(2):273-280. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27986577/. DOI: 10.1016/j.soard.2016.01.034
Contartese D, Salamanna F, Brogini S, Martikos K, Griffoni C, Ricci A, Visani A, Fini M, Gasbarrini A. Fast-track protocols for patients undergoing spine surgery: a systematic review. BMC Musculoskeletal Disorders. 2023;24:57. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869597/. DOI: https://doi.org/10.1186/s12891-022-06123-w
Fernandes AMA, Mansur AJ, Canêo LF, Lourenço DD, Piccioni MA, Franchi SM, Afiune CMC, Gadilo JW, Oliveira AS, Ramires JAF. Redução do período de internação e de despesas no atendimento de portadores de cardiopatias congênitas submetidos à intervenção cirúrgica cardíaca no protocolo da via rápida. Arquivos Brasileiros de Cardiologia. 2004;83(1):1-9. Disponível em: https://www.scielo.br/j/abc/a/XY7qPVBdYnfCQxrB67Rhkpm/?lang=pt. DOI: https://doi.org/10.1590/S0066-782X2004001300003
Santos KM dos, Amorim AVC, Botrel e Silva SR. Fast-tracking em anestesia ambulatorial. Revista Médica de Minas Gerais. 2010;20. Disponível em: http://rmmg.org/artigo/detalhes/1016
Reed B, Tabone LE, Tabone JK, Szoka N, Abunnaja S, Bailey K. The use of an activity tracker to objectively measure inpatient activity after bariatric surgery. Surgery for Obesity and Related Diseases. 2021;17(1):90-95. Disponível em: ttp://dx.doi.org/10.1016/j.soard.2020.08.033. DOI: 10.1016/j.soard.2020.08.033
Kelles SM Bruschi, Diniz MFHS, Machado CJ, Barreto SM. Perfil de pacientes submetidos à cirurgia bariátrica, assistidos pelo Sistema Único de Saúde do Brasil: revisão sistemática. Cadernos de Saúde Pública. 2015;31(8):1587-1601. DOI: 10.1590/0102-311X00022714
Paisani DM, Chiavegato LD, Faresin SM. Volumes, capacidades pulmonares e força muscular respiratória no pós-operatório de gastroplastia. Jornal Brasileiro de Pneumologia. 2005;31(2):125-132. Disponível em: https://www.scielo.br/j/jbpneu/a/5qHMkSNCWrJTfwv97yHPSyh/?lang=en. DOI: 10.1590/S1806-37132005000200007
Leitner DR, Frühbeck G, Yumuk V, Schindler K, Micic D, Woodward E, Toplak H. Obesity and Type 2 Diabetes: two diseases with a need for combined treatment strategies - easo can lead the way. Obesity Facts. 2017;10(5):483-492. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741209/. DOI: 10.1159/000480525
Zhou B, Ji H, Liu Y, Chen Z, Zhang N, Cao X, Meng H. ERAS reduces postoperative hospital stay and complications after bariatric surgery. Medicine. 2021;100(47):e27831. DOI: 10.1097/MD.0000000000027831
Kaye AD, Urman RD, Cornett EM, Hart BM, Chami A, Gayle JA, Fox CJ. Enhanced recovery pathways in orthopedic surgery. J Anaesthesiol Clin Pharmacol. 2019;35(2):35-39. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515716/. DOI: 10.4103/joacp.JOACP_35_18
Małczak P, Pisarska M, Piotr M, Wysocki M, Budzyński A, Pędziwiatr M. Enhanced Recovery after Bariatric Surgery: systematic review and meta-analysis. Obesity Surgery. 2016;27(1):226-235. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27817086/. DOI: 10.1007/s11695-016-2438-z
Elliott JA, Patel VM, Kirresh A, Ashrafian H, Le Roux CW, Olbers T, Athanasiou T, Zacharakis E. Fast-track laparoscopic bariatric surgery: a systematic review. Updates In Surgery. 2013;65(2):85-94. Disponível em: http://dx.doi.org/10.1007/s13304-012-0195-7. DOI: 10.1007/s13304-012-0195-7
Svensson-Raskh A, Schandl AR, Ståhle A, Nygren-Bonnier M, Fagevik Olsén M. Mobilization started within 2 hours after abdominal surgery improves peripheral and arterial oxygenation: a single-center randomized controlled trial. Physical therapy. 2021;101(1):1-11. DOI: doi.org/10.1093/ptj/pzab094
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