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Vol. 38. Issue 2.
Pages 72-76 (February 2002)
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Vol. 38. Issue 2.
Pages 72-76 (February 2002)
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Recuperación de la función pulmonar tras colecistectomía laparoscópica: papel del dolor postoperatorio
Recovery of lung function after laparoscopic cholecystectomy: the role of postoperative pain
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M. de la Peña, B. Togores, M. Bosch
A. Maimob, S. Abada, P. Garridoc, J.A. Soroa, A.G.N. Agustíb,
Corresponding author
aagusti@hsd.es

Correspondencia: Dr. A. G.N. Agustí. Servicio de Neumología. Hospital Universitario Son Dureta. Andrea Doria, 55. 07014 Palma Mallorca
a Cirugía Digestiva. Hospital Universitario Son Dureta. Palma de Mallorca. Sección Neumología Complejo Hospitalario de Mallorca
b Servicio de Neumología. Hospital Universitario Son Dureta. Palma de Mallorca. Sección Neumología Complejo Hospitalario de Mallorca
c Anestesiología. Hospital Universitario Son Dureta. Palma de Mallorca. Sección Neumología Complejo Hospitalario de Mallorca
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Objetivos Del Estudio

Estudios previos han demostrado que la función pulmonar se deteriora tras colecistectomía la-paroscópica (CL). Este estudio evalúa: a) el ritmo de recu-peración de la misma tras CL, y b) el papel etiopatogénico del dolor postoperatorio en dicho deterioro funcional

Diseño

Se midió la función pulmonar: a) 24 h antes de CL; b) en el momento del alta hospitalaria (48–72 h después de CL), y c) 10 días después. Todos los pacientes recibieron metamizol tras la CL hasta el alta (2g/6 h i.v.). La mitad de ellos (grupo analgesia) recibieron, además, tramadol (150mg i.m.) 30 min antes de evaluar la función pulmonar el día del alta hospitalaria (el resto de participantes constituyó el grupo control)

Pacientes

Un total de 20 sujetos sanos (52 ± 4 años) so-metidos a CL para extirpación de vesícula biliar. Todos fir-maron el consentimiento informado

Medidas Y Resultados

Los resultados antropométricos y funcionales preoperatorios fueron iguales en ambos grupos. El tiempo de CL y la evolución postoperatoria también fue similar (todos los pacientes fueron dados de alta sin compli-caciones dentro de las primeras 72 h tras CL). En el mo-mento del alta la función pulmonar (FVC, FEV1, TLC, PaO2 y AaPO2 ) había empeorado en ambos grupos (p <.0,001). Este deterioro fue menos marcado en el grupo analgesia (p < 0,05). Diez días después, la función pulmonar se había nor-malizado en todos los sujetos

Conclusiones

Estos resultados muestran que tras CL: a) la función pulmonar todavía es anormal cuando el paciente es dado de alta del hospital; b) se ha recuperado totalmente 10 días después, y c) el dolor postoperatorio contribuye de forma significativa a su deterioro temporal

Palabras clave:
Analgesia
Colecistectomía laparoscópica
Función pulmonar
Cirugía
Objectives

Lung function has been shown to deteriorate after laparoscopic cholecystectomy (LC). The present study evaluated 1) the rate of recovery after LC, and 2) the patho-genic role of postoperative pain in functional deterioration

Design

Lung function was measured 24 hours before LC, upon hospital discharge (48–72 h after LC), and 10 days later. All patients received metamizol after LC until discharge (2g every 6 h i.v.). Half the patients (analgesia group) received tramadol (150mg i.m.) 30 minutes before lung function testing on the day of hospital discharge. The remaining patients constituted the control group

Patients

Twenty healthy subjects (53 ± 4 years old) undergoing LC for gall bladder removal. All signed informed consent forms

Measures and Outcomes

Patient characteristics and preoperative lung function results were similar in both groups. LC duration and postoperative course were also similar in both groups. All were discharged without complications with-in 72 hours after LC. Lung function upon discharge (FVC, FEV1, TLC, PaO2 and AaPO2 ) had deteriorated in both groups (p < 0.001). Deterioration was less marked in the analgesia group (p < 0.05). Ten days later, lung function had normalized for all subjects

Conclusions

These results indicate that after LC, 1) lung function is still abnormal when the patient is discharged from hospital, 2) lung function has fully recovered within 10 days, and 3) postoperative pain contributes signifi-cantly to temporary deterioration in lung function

Keywords:
Analgesia
Laparoscopic cholecystectomy
Lung function
Surgery
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Copyright © 2002. Sociedad Española de Neumología y Cirugía Torácica
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