Ana Beatriz Sasseron

Does the pain disturb the respiratory function after open heart surgery

OBJECTIVE The post operative pain after open heart surgeries had been often reported. Meager reports about respiratory function and pain correlation had been reported. The aim of this article is to assess the pain intensity and location during hospital admittance and its effect on pulmonary function in patients underwent elective cardiac surgery. METHODS Pulmonary function (lung volumes, respiratory pressures and peak expiratory flow) was assessed at the preoperative and post-operative time (1, 3 and 5 days) by ventilometer, manovacuometer and peak flow meter measurements. The assessment of pain intensity was carried out with a visual analogue scale for pain. RESULTS The majority of pain site was on sternotomy incision (50% of patients) and the intensity was higher at the first postoperative day (8.32 by visual scale measurement). All pulmonary variables decreased on post-operative time when compared to baseline values. All respiratory variables remained lower than to pre-operative time at fifth postoperative time (P > 0.05), with exception for respiratory rate. The pain and maximal inspiratory pressure showed a negative correlation at the first postoperative day (P = 0.019). CONCLUSION Postoperative pain decreased lung function in patients precluding deep inspirations, in special, at the first post-operative day.

Comparação entre o uso de bocal e máscara facial na avaliação de volumes pulmonares e capacidade vital em indivíduos saudáveis

Testes de funcao pulmonar sao usados para determinar a gravidade, as consequencias funcionais e o progresso de disfuncoes pulmonares e neuromusculares. As variacoes metodologicas com o bocal e a mascara facial e a cooperacao do paciente podem interferir no desempenho das manobras e afetar as medidas. O objetivo deste estudo foi comparar os valores de volumes pulmonares (volume corrente [Vc], volume-minuto [Vm]), frequencia respiratoria (FR) e capacidade vital (CV) em individuos saudaveis quando avaliados por meio do bocal e da mascara facial. Participaram do estudo 60 voluntarios saudaveis, 14 homens e 46 mulheres, com media de idade de 22,9±7,1 anos. Para a avaliacao com bocal, utilizou-se uma peca semirrigida descartavel e clipe nasal; a mascara usada foi facial plastica com borda pneumatica inflavel. As medidas obtidas foram comparadas estatisticamente (nivel de significância 5%). Os valores obtidos com o bocal e com a mascara facial foram, respectivamente: FR, 15 rpm x 13 rpm (p<0,01); Vm, 14,87 l/min x 10,02 l/min (p<0,01); Vc, 0,93 l x 0,8 l (p<0,01); CV, 3,85 l x 3,52 l (p<0,01). Os valores de volumes pulmonares e capacidade vital mostraram-se pois significativamente inferiores quando avaliados com a mascara facial em comparacao ao bocal.

Análise comparativa da função respiratória de indivíduos hígidos em solo e na água

Measuring respiratory function provides essential information to assess pulmonary changes. Effects of water hydrostatic pressure on the submerged chest cause changes in the respiratory system. The purpose here was to compare respiratory function variables - minute volume (MV), tidal volume (TV), vital capacity (Vitalc), and respiratory rate (RR) - on the ground and with chest submerged in water. Respiratory function of 30 healthy female volunteers (mean age 20.93 ± 2.11; weight 58.8±9.2 kg; body mass index 21.78±2.63 kg/m²) was assessed by spirometry on the ground, and 1 and 20 minutes after immersion in warm water at shoulder level in the sitting position. As compared to ground levels, statistically significant increases were found in MV (p=0.015) and TV (p=0.027) 20 minutes after immersion, as well as a significant decrease (p=0.016) in Vitalc one minute after immersion. Longer time immersion has thus altered values obtained on ground, except for Vitalc, which showed significant reduction on the first minute after chest immersion. Comparison between variable values obtained 1 and 20 minutes in water showed no significant difference. It may thus be said that chest submersion in warm water caused an increase in MV and VT and a decrease in Vitalc of healthy subjects.