Comparing the Effect of Incentive Spirometry and Deep Breathing Exercise on Hemodynamic Indicators and Pulmonary Complications During and after Gastric Sleeve Surgery

Pulmonary complications after surgery not only result in long-term hospitalization but also cause more complications and mortality. These complications can include atelectasis, pneumonia, bronchospasm, and even death. Measures to improve lung function include incentive spirometry, deep breathing exercises, etc. This research aimed to investigate the effect of incentive spirometry and deep breathing exercises on hemodynamic indicators (oxygen saturation level, PCO2, PH, blood pressure, heart rate) and pulmonary complications during and after gastric sleeve surgery.

Our study was an interventional one, participants were 75 patients who were referred to Imam Khomeini Hospital in Tehran in 2022 for sleeve operation. Using a simple random sampling method and block randomization and random numbers table, patients were divided into two intervention groups and one control group. Patients in the first intervention group used incentive spirometry two hours before the operation and two and six hours after the operation, and after the procedure, the patient's hemodynamic indicators were recorded by the researcher, the second intervention group used deep breathing exercises in the same order as the first group. and the hemodynamics of the patients were recorded in the same way. No special measures were taken in the control group. To check the effectiveness, the incidence of atelectasis and pneumonia (up to two weeks after the operation by referring to the patient's file and examination of clinical symptoms by an expert) and the length of stay of the patients in the hospital were checked.

Results showed that the use of incentive spirometry and deep breathing exercises in improving the oxygenation of patients undergoing sleeve surgery during and after the operation was not significant (P>0.05). No significant difference was found in the blood PH of the patients (P>0.05). Also, no significant difference was found in the heart rate of the patients during and after the operation (P>0.05). In the hemodynamic examinations, the blood pressure of the patients in these two intervention groups significantly improved compared to the control group (P<0.05). There was no significant difference in the rate of pulmonary complications after the operation among the three groups (P>0.05).

The use of incentive spirometry and deep breathing exercises improved the oxygenation and heart rate of patients undergoing gastric sleeve surgery before surgery, but they were not effective during and after the operation. They did not affect postoperative pulmonary complications and none of these two methods was superior to the other.