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Title: Orthostatic intolerance during early mobilization following video-assisted thoracic surgery.
Authors: Mizota, Toshiyuki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0003-2770-4262 (unconfirmed)
Iwata, Yoshika
Daijo, Hiroki  kyouindb  KAKEN_id
Koyama, Tomohiro
Tanaka, Tomoharu  kyouindb  KAKEN_id
Fukuda, Kazuhiko  kyouindb  KAKEN_id
Author's alias: 溝田, 敏幸
Keywords: Orthostatic intolerance
Video-assisted thoracic surgery
Opioids
Ambulation
Analgesia
Issue Date: 14-May-2013
Publisher: Springer Japan
Journal title: Journal of anesthesia
Volume: 27
Issue: 6
Start page: 895
End page: 900
Abstract: [Purpose]Early postoperative mobilization is crucial for early ambulation to reduce postoperative pulmonary complications after lung resection. However, orthostatic intolerance (OI) may delay patient recovery, leading to complications. It is therefore important to understand the prevalence of and predisposing factors for OI following video-assisted thoracic surgery (VATS), which have not been established. This study evaluated the incidence of OI, impact of OI on delayed ambulation, and predisposing factors associated with OI in patients after VATS. [Methods]This retrospective cohort study consecutively analyzed data from 236 patients who underwent VATS. The primary outcome was defined as OI with symptoms associated with ambulatory challenge on postoperative day 1 (POD1), including dizziness, nausea and vomiting, feeling hot, blurred vision, or transient syncope. Multivariate logistic regression was performed to identify independent factors associated with OI. [Results]Of the 236 patients, 35.2 % (83) experienced OI; 45.8 % of these could not ambulate at POD1, compared with 15.7 % of patients without OI (P < 0.001). Factors independently associated with OI included advanced age [odds ratio 2.83 (1.46–5.58); P = 0.002], female gender [odds ratio 2.40 (1.31–4.46); P = 0.004], and postoperative opioid use [odds ratio 2.61 (1.23–5.77); P = 0.012]. Use of thoracic epidural anesthesia was not independently associated with OI [odds ratio 0.72 (0.38–1.37); P = 0.318]. [Conclusion]Postoperative OI was common in patients after VATS and significantly associated with delayed ambulation. Advanced age, female gender, and postoperative opioid use were identified as independent predisposing factors for OI.
Rights: The final publication is available at Springer via http://dx.doi.org/10.1007/s00540-013-1634-4
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
URI: http://hdl.handle.net/2433/196866
DOI(Published Version): 10.1007/s00540-013-1634-4
PubMed ID: 23670803
Appears in Collections:Journal Articles

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