Prophylaxis against pulmonary complications in patients undergoing gall-bladder surgery. A comparison between early mobilization, physiotherapy with and without bronchodilatation.

A random comparison of early mobilization and chest physiotherapy (mainly breathing exercises) with or without bronchodilatating inhalations for prophylaxis against pulmonary complications in patients undergoing elective gall-bladder surgery is presented. The operation was performed with a subcostal incision and peroperatively, intercostal nerve block was administered. Preoperative pulmonary status (dynamic volume spirometry, peak expiratory flow rate, arterial blood gas analysis) showed no differences between the groups, and postoperative blood gas analysis and pulmonary X-ray or evident clinical findings did also not show any differences between the groups. Thus early mobilization was as effective in our study as the other prophylactic treatments. In patients without pulmonary disease perhaps early mobilization and efficient analgesia after surgery is as effective as more resource demanding physiotherapy for prophylaxis against postoperative pulmonary complications.