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The aim of this observational study is to compare the effects of preoperative breathing exercises during the preoxygenation period in patients undergoing abdominal surgery.
Patients who are planned for abdominal surgery under elective conditions and who meet the inclusion criteria will be divided into 2 groups after routine preoperative preparations. The 1st group will start at least 5 days before the preoperative period and until the preoperative period, a minimum of 5 minutes of effective triflo exercise will be performed 4 times a day under the supervision of a nurse, and the 2nd group (control group) will not be exercised except for routine preoperative preparation. Age, existing chronic diseases, body mass index, haemoglobin levels, smoking status, presence or absence of lung disease, SpO2 values before and at the end of respiratory exercise (in the preoperative respiratory exercise group) will be recorded. All patients will be monitored with ECG, SpO2, non invasive blood pressure, Masimo. After the patients are taken to the operating table, they will be preoxygenated with oxygen at FiO2 100% at 10 L\min in supine position, with the anaesthesia mask placed on the patient's face so that there is no leakage. Patients will be preoxygenated until ETO2 concentration reaches 85%. When preoxygenation is started, the timer will be started and the time to reach ORI:0.55 and the time to reach ETO2 85% will be measured and recorded with a timer. Preoxygenation time will be limited to a maximum of 5 minutes and patients who do not reach ETO2 concentration 85% or ORI:0.55 within 5 minutes will be noted.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control (C) | Patients in the control group who will undergo abdominal surgery will not be given any breathing exercises other than routine preoperative preparation. After appropriate anesthesia preparation, preoxygenation will begin. | ||
| Triflo (T) | The patient group who receives breathing exercises will be given effective triflo exercise under the supervision of a nurse, starting with hospitalization at least 5 days before the operation and until the pre-operative period. Triflo working time will be planned to be minimum 5 minutes 4 times a day. Breathing exercise will be performed with both inhalation and exhalation. After appropriate anesthesia preparation, preoxygenation will begin. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative respiratory exercises | Procedure | The Triflo Exerciser |
|
| Measure | Description | Time Frame |
|---|---|---|
| Duration (sec) for end-tidal oxygen level to rise to 85% | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for oxygen reserve index to rise to 0.55 | The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) | Between 0th minute and 5th minute of preoxygenation period |
| Measure | Description | Time Frame |
|---|---|---|
| Duration (sec) for end-tidal oxygen level to rise to 85% according to patient's age | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) according to patient's age | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for oxygen reserve index to rise to 0.55 according to patient's age |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who will undergo elective abdominal surgery under general anesthesia in Ankara Bilkent City Hospital Operating Room, between the ages of 18-65, both genders and ASA I-III risk group who agree to participate in the study will be included.
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| Name | Affiliation | Role |
|---|---|---|
| Nermin Gögüş | Ankara Bilkent City Hospital, Anesthesiology and Reanimation Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Bilkent City Hospital | Ankara | Çankaya | 06530 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29367198 | Background | Boden I, Skinner EH, Browning L, Reeve J, Anderson L, Hill C, Robertson IK, Story D, Denehy L. Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial. BMJ. 2018 Jan 24;360:j5916. doi: 10.1136/bmj.j5916. | |
| 17047215 |
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The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) according to patient's age |
| Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for end-tidal oxygen level to rise to 85% according to patient's BMI | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) according to patient's BMI | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for oxygen reserve index to rise to 0.55 according to patient's BMI | The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) according to patient's BMI | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for end-tidal oxygen level to rise to 85% according to patient's gender | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) according to patient's gender | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for oxygen reserve index to rise to 0.55 according to patient's gender | The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) according to patient's gender | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for end-tidal oxygen level to rise to 85% depending on whether the patients had known lung disease or not. | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) depending on whether the patients had known lung disease or not. | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for oxygen reserve index to rise to 0.55 depending on whether the patients had known lung disease or not. | The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) depending on whether the patients had known lung disease or not. | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for end-tidal oxygen level to rise to 85% according to patient's hemoglobin level | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) according to patient's hemoglobin level | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for oxygen reserve index to rise to 0.55 according to patient's hemoglobin level | The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) according to patient's hemoglobin level | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for the end-tidal oxygen level to rise to 85% according to whether the patient smokes or not | The investigators aimed to compare the duration for end-tidal oxygen level to rise 85% of two groups (C and T) according to whether the patient smoked or not. | Between 0th minute and 5th minute of preoxygenation period |
| Duration (sec) for the oxygen reserve index to rise to 0.55 according to whether the patient smokes or not | The investigators aimed to compare the duration for oxygen reserve index to rise to 0.55 of two groups (C and T) according to whether the patient smoked or not. | Between 0th minute and 5th minute of preoxygenation period |
| Oxygen saturation level (%) at the beginning and end of 5-day triflo exercise | The investigators aimed to examine whether there was a significant difference between oxygen saturations before the start of the study and at the end of the 5-day study in the group of patients who underwent Triflo exercise (T). | In the preoperative period before the initiation of triflo exercise and before preoxygenation after 5 days of triflo exercise |
| Hulzebos EH, Helders PJ, Favie NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NL. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA. 2006 Oct 18;296(15):1851-7. doi: 10.1001/jama.296.15.1851. |
| 20551816 | Background | Kundra P, Vitheeswaran M, Nagappa M, Sistla S. Effect of preoperative and postoperative incentive spirometry on lung functions after laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2010 Jun;20(3):170-2. doi: 10.1097/SLE.0b013e3181db81ce. |
| 31904726 | Background | Chen ST, Min S. Oxygen reserve index, a new method of monitoring oxygenation status: what do we need to know? Chin Med J (Engl). 2020 Jan 20;133(2):229-234. doi: 10.1097/CM9.0000000000000625. |
| 28791567 | Background | Scheeren TWL, Belda FJ, Perel A. The oxygen reserve index (ORI): a new tool to monitor oxygen therapy. J Clin Monit Comput. 2018 Jun;32(3):379-389. doi: 10.1007/s10877-017-0049-4. Epub 2017 Aug 8. |