Postoperative Outcomes Following Preoperative Respiratory Muscle Exercise in Patients Undergoing Abdominal Surgery: A Narrative Review

Abdominal surgeries are the most common operative procedures including a wide range of both emergency and elective surgical interventions. Postoperative Pulmonary Complications (PPCs) following upper abdominal surgery are the most common surgical complications. The combined effect of surgical trauma and anaesthesia results in reduced lung volumes and respiratory muscle dysfunction. Chest physical therapy is widely recommended to prevent and treat PPCs, using a wide variety of techniques and devices, including incentive spirometry, continuous positive airway pressure, positive expiratory pressure, intrapulmonary percussive ventilation and Inspiratory Muscle Training (IMT) using a pressure threshold device that targets the muscles of inspiration. The present narrative review aimed to determine the available literature to evaluate whether preoperative respiratory muscle training is effective on pulmonary function test, Respiratory Muscle Strength (RMS) and preventing PPCs after abdominal surgery. A computer-based literature search was done using the PubMed, PubMed Central, Science Direct and Google Scholar. Relevant articles with full text published in English from 1995 to 2021 were screened and included. Studies were included which had preoperative physiotherapy techniques on patients undergoing abdominal surgery. Editorials, commentaries, discussion papers, conference abstracts, reviews and duplicates were excluded. After screening, only studies with full text articles were included that comprised of nine relevant articles. It is imperative to discover the probable outcome of preoperative respiratory exercises training. Hence, a review could be helpful in delivering a perception about which exercises program could cause improved and enhanced postoperative outcome.