Zeiderman M R, Welchew E A, Clark R G
University Department of Surgery, Sheffield, UK.
Br J Surg. 1990 May;77(5):576-80. doi: 10.1002/bjs.1800770536.
An understanding of the factors which contribute to postoperative fatigue may benefit the rehabilitation of patients after surgery. Subjective feelings of fatigue and fatigue measured objectively in the adductor pollicis muscle after ulnar nerve stimulation have been studied in relation to changes in cardiorespiratory function and muscular efficiency both at rest and when walking on a treadmill at a work rate of 20 and 56 kpm min-1. Twelve patients admitted for elective abdominal surgery were studied before operation and again on the third postoperative day. The postoperative period was characterized by an increased feeling of fatigue. Surgery had no effect upon fatigue in the adductor pollicis muscle suggesting that the genesis of postoperative fatigue is partly central in origin. Muscular efficiency (s.d.) fell from 34(6) per cent before operation to 22(3) per cent (P less than 0.05) on the third postoperative day and was accompanied by a 19 per cent rise in the net energy (s.d.) expenditure (7.3(0.8) to 8.6(0.3) kJ min-1; P less than 0.03) required to perform a given workload. The increased cardiorespiratory effort and reduced muscular efficiency associated with the performance of low-intensity exercise may limit mobilization after surgery and contribute to a greater feeling of fatigue.
了解导致术后疲劳的因素可能有助于术后患者的康复。研究了尺神经刺激后拇内收肌的主观疲劳感和客观测量的疲劳程度，以及静息状态下和以20和56千帕米每分钟的工作速率在跑步机上行走时心肺功能和肌肉效率的变化。对12例择期腹部手术患者在术前和术后第三天进行了研究。术后期间的特点是疲劳感增加。手术对拇内收肌的疲劳没有影响，这表明术后疲劳的产生部分源于中枢。肌肉效率（标准差）从术前的34（6）%降至术后第三天的22（3）%（P<0.05），同时完成给定工作量所需的净能量（标准差）支出增加了19%（从7.3（0.8）千焦每分钟增至8.6（0.3）千焦每分钟；P<0.03）。与低强度运动表现相关的心肺努力增加和肌肉效率降低可能会限制术后的活动，并导致更大的疲劳感。
