Evaluation of Upper Extremity Movement, Pain Intensity, and Respiratory Functions in Patients Who Received Thoracotomy Sparing the Serratus Anterior Muscle

Evaluation of Upper Extremity Movement, Pain Intensity, and Respiratory Functions in Patients Who Received Thoracotomy Sparing the Serratus Anterior Muscle

Objective: To evaluate upper extremity movement, pain intensity, and respiratory functions in preoperative and postoperative periods in patients undergoing thoracotomy sparing the serratus anterior muscle (TSSAM). Methods: Forty-three patients (25 male and 18 female) were included in this prospective observational cohort type study. In the preoperative period and on postoperative days 1, 2, 3, and 5, ipsilateral shoulder range of motion was evaluated by a goniometer, pain intensity was evaluated by a visual analog scale (VAS), and respiratory functions were evaluated by spirometry. Results: When compared with preoperative values, shoulder flexion and abduction angle, forced expiratory volume in 1 second (FEV1), and functional vital capacity (FVC) decreased on postoperative day 1, while VAS significantly increased (P < .05). Shoulder flexion and abduction angle, FEV1, and FVC significantly increased and VAS significantly decreased on postoperative days 2, 3, and 5 compared to postoperative day 1 (P < .05). However, they could not reach preoperative values on postoperative day 5 (P < .05). On postoperative day 1, while there was a correlation between pain and flexion (r=−0.438; P=.003) and abduction (r=−0.503; P=.001) angles, no correlation was found between pain and FEV1 (r=−0.189; P=.225) and FVC (r=0.009; P=.953). There was no correlation between pain and flexion, abduction, FEV1, and FVC on postoperative days 2,3, and 5 (P > .05). Conclusions: Patients undergoing the TSSAM had less upper extremity range of motion and respiratory functions and more pain intensity in the early postoperative period than in the preoperative period. It was observed that pain and flexion and abduction angles were negatively correlated on postoperative day 1. In the postoperative period, they should be taken into account in the design/development of rehabilitation programs.

___

  • 1. Park S, Gu JH, Jang HK, Oh MS, Lee EJ, Jung IC. Electroacupuncture for post-thoracotomy pain: protocol for a systematic review and meta-analysis. Med (Baltim). 2020;99(9):e19312. [CrossRef]
  • 2. Alzahrani T. Pain relief following thoracic surgical procedures: a literature review of the uncommon techniques. Saudi J Anaesth. 2017;11(3):327-331. [CrossRef]
  • 3. Bernstein DT, Zhuge W, Blackmon SH, Marco RAW. A novel musclesparing high thoracotomy for upper thoracic spine resection and reconstruction. Eur Spine J. 2018;27(7):1567-1574. [CrossRef]
  • 4. Elshiekh MA, Lo TT, Shipolini AR, McCormack DJ. Does muscle-sparing thoracotomy as opposed to posterolateral thoracotomy result in better recovery? Interact Cardiovasc Thorac Surg. 2013;16(1):60- 67. [CrossRef]
  • 5. Neumann DA, Camargo PR. Kinesiologic considerations for targeting activation of scapulothoracic muscles - part 1: Serratus anterior. Braz J Phys Ther. 2019;23(6):459-466. [CrossRef]
  • 6. Campbell ST, Ecklund KJ, Chu EH, McGarry MH, Gupta R, Lee TQ. The role of pectoralis major and latissimus dorsi muscles in a biomechanical model of massive rotator cuff tear. J Shoulder Elbow Surg. 2014;23(8):1136-1142. [CrossRef]
  • 7. Gerner P. Postthoracotomy pain management problems. Anesthesiol Clin. 2008;26(2):355-367, vii. [CrossRef]
  • 8. Kutlu CA, Akin H, Olcmen A, Biliciler U, Kayserilioglu A, Olcmen M. Shoulder-girdle strength after standard and lateral muscle-sparing thoracotomy. Thorac Cardiovasc Surg. 2001;49(2):112-114. [CrossRef]
  • 9. Khelemsky Y, Noto CJ. Preventing post-thoracotomy pain syndrome. Mt Sinai J Med. 2012;79(1):133-139. [CrossRef]
  • 10. Wenk M, Schug SA. Perioperative pain management after thoracotomy. Curr Opin Anaesthesiol. 2011;24(1):8-12. [CrossRef]
  • 11. Landreneau RJ, Pigula F, Luketich JD, et al. Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg. 1996;112(5):1346-50. [CrossRef]
  • 12. Akçali Y, Demir H, Tezcan B. The effect of standard posterolateral versus muscle-sparing thoracotomy on multiple parameters. Ann Thorac Surg. 2003;76(4):1050-1054. [CrossRef]
  • 13. Cobanoğlu U, Hız O, Melek M, Edirne Y. Is muscle-sparing thoracotomy advantageous. Turk J Thorac Cardiovasc Surg. 2011;19(1):43-48.
  • 14. Heitmiller RF. The serratus sling: a simplified serratus-sparing technique. Ann Thorac Surg. 1989;48(6):867-868. [CrossRef]
  • 15. Husch HH, Watte G, Zanon M, et al. Effects of transcutaneous electrical nerve stimulation on pain, pulmonary function, and respiratory muscle strength After posterolateral thoracotomy: a randomized controlled trial. Lung. 2020;198(2):345-353. [CrossRef]
  • 16. Boisseau N, Rabary O, Padovani B, et al. Improvement of ‘dynamic analgesia’ does not decrease atelectasis after thoracotomy. Br J Anaesth. 2001;87(4):564-569. [CrossRef]
  • 17. Marshall K, McLaughlin K. Pain management in thoracic surgery. Thorac Surg Clin. 2020;30(3):339-346. [CrossRef]
  • 18. Elswick SM, Blackmon SH, Sharaf B. Muscle-sparing thoracotomy. Oper Tech Thorac Cardiovasc Surg. 2017;22(2):110-121. [CrossRef]
  • 19. Krishnan R, Björsell N, Gutierrez-Farewik EM, Smith C. A survey of human shoulder functional kinematic representations. Med Biol Eng Comput. 2019;57(2):339-367. [CrossRef]
  • 20. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg. 1998;86(1):102-106. [CrossRef]
  • 21. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993;16:5-40.
  • 22. Hazelrigg SR, Landreneau RJ, Boley TM, et al. The effect of musclesparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain. J Thorac Cardiovasc Surg. 1991;101(3):394-400; discussion 400 [discussion]. [CrossRef]
  • 23. Öztürk M. Standart posterolateral Torakotomiyle serratus anterior Kasını Koruyucu Torakotominin Çok Değişkenli Karsılaştırılması Erciyes Üniversitesi Tıp Fakültesi, Tıpta Uzmanlık Tezi. 2007.
  • 24. Athanassiadi K, Kakaris S, Theakos N, Skottis I. Muscle-sparing versus posterolateral thoracotomy: a prospective study. Eur J Cardiothorac Surg. 2007;31(3):496-499. [CrossRef]
  • 25. El-Hag-Aly MA, Hagag MG, Allam HK. If post-thoracotomy pain is the target, integrated thoracotomy is the choice. Gen Thorac Cardiovasc Surg. 2019;67(11):955-961. [CrossRef]
  • 26. Scawn ND, Pennefather SH, Soorae A, Wang JY, Russell GN. Ipsilateral shoulder pain after thoracotomy with epidural analgesia: the influence of phrenic nerve infiltration with lidocaine. Anesth Analg. 2001;93(2):260-264. [CrossRef]
  • 27. Uzzaman MM, Robb JD, Mhandu PC, et al. A meta-analysis comparing muscle-sparing and posterolateral thoracotomy. Ann Thorac Surg. 2014;97(3):1093-1102. [CrossRef]
  • 28. Solak O, Turna A, Pekcolaklar A, et al. Transcutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomized prospective study. Thorac Cardiovasc Surg. 2007;55(3):182- 185. [CrossRef]
  • 29. Ponn RB, Ferneini A, D'Agostino RS, Toole AL, Stern H. Comparison of late pulmonary function after posterolateral and muscle-sparing thoracotomy. Ann Thorac Surg. 1992;53(4):675-679. [CrossRef]
  • 30. Miyoshi S, Yoshimasu T, Hirai T, et al. Exercise capacity of thoracotomy patients in the early postoperative period. Chest. 2000; 118(2):384-390. [CrossRef]
European Journal of Therapeutics-Cover
  • ISSN: 2564-7784
  • Başlangıç: 1990
  • Yayıncı: Fatma Taşçı
Sayıdaki Diğer Makaleler

The Impact of COVID-19 Outbreak on Electrophysiological Procedures: A Single-Center Tertiary Experience

Ahmet Hakan ATEŞ, Hikmet YORGUN, Kudret AYTEMİR, Burak SEZENÖZ

The Prognostic Importance of Neutrophil-toLymphocyte Ratio and Platelet-toLymphocyte Ratio in Adult Patients with Sepsis Who Underwent Hemoperfusion in General Intensive Care Unit

Türkan ÖZER, Suna KOÇ, Mehmet KARADAĞ, Hakan KAPTANOĞULLARI, Taner Şerif KÜÇÜKCERİT, Burcu KARAOĞUZ, Yunus Emre CELEP, Emre AKTEPE, Hacer DİZMEN, Betül TULUM, Elif KUAS, Aslıhan İLERİ, Sema Nur DOKUR, Mehmet DOKUR

Food Allergy and Philagrine Mutation in Children with Atopic Dermatitis

Gülşah DUYULER AYÇİN

Advanced Proliferative Diabetic Retinopathy

Mücella ARIKAN YORGUN

Effectiveness of De Ritis (AST/ALT) Ratio in Predicting Biochemical Recurrence in Patients Underwent Radical Prostatectomy for Localized Prostate Cancer

Samet ŞENEL, Öner ODABAŞ, Sedat TAŞTEMUR, Yusuf KASAP

Evaluation of Upper Extremity Movement, Pain Intensity, and Respiratory Functions in Patients Who Received Thoracotomy Sparing the Serratus Anterior Muscle

Savaş GÜRSOY, Maruf ŞANLI, Seval KUL, Yasemin KARAASLAN, Ali CIMBIZ, Ayça ARACI

Laparoscopic Ovarian Drilling Improve Endometrial Receptivity by Increasing Production of Endometrial Metabolites

Cemil KARAKUŞ

Investigation of the Antioxidant, Antimicrobial, and Cytotoxic Activities of Endemic Marrubium rotundifolium Boiss

Fadime AYDIN KÖSE, İsmail ÖZTÜRK, Şüra BAYKAN, Seden CİN

A New and Practical Method for Transmission Electron Microscopy Analysis of Proteus mirabilis

Ebru BALLI, Banu COŞKUN YILMAZ, Deniz GAZEL, Mehmet ERİNMEZ, Hadiye DEMİRBAKAN

Temporal Inverted Internal Limiting Membrane Flap Technique for the Treatment of Macular Holes

Mücella ARIKAN YORGUN, Yasin TOKLU, Burak TANRIVERDİ, Mehmet İÇÖZ