Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, PO Box 93311, Otahuhu, Auckland, New Zealand.
Surg Endosc. 2012 Jun;26(6):1730-6. doi: 10.1007/s00464-011-2101-7. Epub 2012 Jan 19.
Fatigue is one of the main complaints after surgery and may last longer than physical symptoms. It prevents return to normal function and activity. Relaxation interventions, performed prior to abdominal surgery, have been shown to reduce pain, wound erythema, and systemic cortisol levels. However, there is a lack of data on the impact of this intervention on patient well-being, functional recovery, activities of daily living, and fatigue after discharge from hospital.
The study was a randomised single-blinded trial. Patients who were to undergo elective laparoscopic cholecystectomy for any indication between April 2008 and May 2010 were screened for inclusion. Those in the intervention group attended a standardised 45 min relaxation session with a health psychologist and were given relaxation exercise CDs to take home. The control group did not have the intervention. Patients were followed for 30 days. Fatigue was measured using the identity-consequence fatigue scale.
Seventy-five patients were randomised. Fifteen patients were excluded after randomization for various reasons; hence, 60 patients were followed up and analysed. Both groups had similar fatigue at baseline. There was improved fatigue and consequence of fatigue on postoperative day 30 in the intervention group. There was no difference in fatigue at any other time point postoperatively.
This was the first interventional study targeting fatigue after laparoscopic cholecystectomy by using a brief psychological relaxation intervention. It has shown a reduction of fatigue and impact of fatigue at 30 days postoperatively in the intervention group.
疲劳是手术后的主要抱怨之一，可能持续时间长于身体症状。它会妨碍恢复正常功能和活动。在腹部手术前进行的放松干预已被证明可以减轻疼痛、伤口红斑和全身皮质醇水平。然而，关于这种干预对患者的幸福感、功能恢复、日常生活活动和出院后疲劳的影响，数据缺乏。
该研究是一项随机单盲试验。筛选了 2008 年 4 月至 2010 年 5 月期间因任何原因接受择期腹腔镜胆囊切除术的患者，以确定其是否符合纳入标准。干预组的患者参加了一个标准化的 45 分钟放松课程，由健康心理学家授课，并获得了放松练习 CD 带回家。对照组没有接受干预。对患者进行了 30 天的随访。使用身份后果疲劳量表来测量疲劳。
75 名患者被随机分配。15 名患者在随机分组后因各种原因被排除在外；因此，对 60 名患者进行了随访和分析。两组患者在基线时的疲劳程度相似。干预组在术后第 30 天的疲劳和疲劳后果均有改善。在术后其他任何时间点，两组的疲劳程度均无差异。
这是第一项通过使用简短的心理放松干预来针对腹腔镜胆囊切除术后疲劳的干预性研究。它显示在干预组中，术后 30 天的疲劳和疲劳影响有所减少。
