The Effects of Early Mobilization on Pain and Quality of Recovery in Patients Undergoing Laparoscopic Cholecystectomy Surgery:

Year 2023, Volume: 4 Issue: 3, 153 - 161, 29.12.2023

İbrahim Okcul , Semra Erdağı Oral

https://doi.org/10.53811/ijtcmr.1342768

Abstract

Objective: This study was conducted to determine the effects of early mobilization on pain and quality of recovery in patients undergoing laparoscopic cholecystectomy.
Materials and methods: Pretest-posttest experimental design with control group. This study was carried out at the General Surgery Inpatient Clinic of a state hospital between April 2021 and January 2022. A total of 90 patients were included in the study. Starting with two hours after surgery, the patients in the experimental group were mobilized at least 6 times in 24 hours. A “Patient Description Form”, the “Visual Analog Scale for Pain”, and the “Quality of Recovery-40 Questionnaire” were used to collect data.
Results: The introductory and medical characteristics of the patients in the intervention and control groups were similar. There was no significant difference between the pain and recovery quality mean scores of the patients in the two groups at the 2nd postoperative hour. The mean pain scores of the patients in the intervention group at the 24th hour and on the 15th day after surgery were found to be significantly lower than the scores of those in the control group. It was found that the mean recovery quality scores of the patients in the intervention group at the 24th hour and on the 15th day after surgery were also higher than those of the patients in the control group.
Conclusions: It was determined that early mobilization reduced the level of pain and increased the quality of recovery in laparoscopic cholecystectomy patients.

Keywords

pain, quality of recovery, early mobilization, laparoscopic cholecystectomy

References

• 1. Warchałowski Ł, Łuszczki E, Bartosiewicz A, et al. The analysis of risk factors in the conversion from laparoscopic to open cholecystectomy. Int. J. Environ. Res. Public Health, 2020;17(20):75-71.
• 2. Hassler KR, Collins JT, Philip K, et al. Laparoscopic Cholecystectomy. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448145/
• 3. Bilecen ME, Aksu Ç. The effect of education on quality of life in accordance with the requirements of patients with laparoscopic cholecystectomy surgery, Health Sci J Adıyaman University, 2022;8(1):37-44.
• 4. Gupta V, Jain G. Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy. WJGS, World J Gastrointest Surg 2019;11(2):62-84.
• 5. Acar K, Aygin D. Pain and nursing care after laparoscopic surgery, OTJHS 2016;(2),17-22.
• 6. Amin A, Haider MI, Aamir IS, et al. Preoperative and operative risk factors for conversion of laparoscopic cholecystectomy to open cholecystectomy in Pakistan. Cureus, 2019;11(8), 1-5,
• 7. Balogun OS, Osinowo AO, Olajide TO, et al. . Development and practice of laparoscopic surgery in a Nigerian tertiary hospital. Nigerian J of Clin Practice, 2020;23(10), 1368-1374, 8. Yağcı Ü, Saygın M. Pain physiopathology. J SDU Faculty of Med, 2019; 26(2):209-220.
• 9. Barazanchi AWH, MacFater WS, Rahiri JL, et al. Evidence-based management of pain after laparoscopic cholecystectomy: A prospect review update. BJA, 2018;121(4):787-803.
• 10. Genç E. The effect of transcutaneous electrical nerve stimulation on pain levels before mobilization in patients undergoing open heart surgery, Medipol University, Institute of Health Sciences, Master Thesis, İstanbul, 2019.
• 11. Garimella V, Cellini C. Postoperative pain control, Clin Colon and Rectal Surg, 2013;26(03):191-196.
• 12. Joshi G, Gandhi K, Shah N, et al. Peripheral nerve blocks in the management of postoperative pain: challenges and opportunities. JCA 2016;35: 524-529.
• 13. Yolcu S, Akın S, Durna Z. The Evaluation of mobility levels of postoperative patients and associated factors. J Educ Res Nurs 2016;13(2):129-138,
• 14. Kırtıl İ, Kanan N. Effect of early mobilization on gastrointestinal functions after abdominal surgery: systematic review, Archives Med Review J, 2021;30(3):166-176,
• 15. Karaçay E. Pre-operative and post-operative pulmonary rehabilitation. Current Chest Diseases Ser, 2019;7 (1): 126-135,
• 16. Birlikbaş S, Bölükbaş N. Enhanced recovery after surgery, Ordu University J Nurs Stud, 2019; 2 (3), 194-205, 17. Shida D, Wakamatsu K, Tanaka Y, et al. The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40. BMC cancer, 2015;15(1):1-6
• 18. Ni CY, Wang ZH, Huang ZP, et al. Early enforced mobilization after liver resection: a prospective randomized controlled trial. International J Surg, 2018:54, 254-258.
• 19. Harikesavan K, Chakravarty RD., Maiya AG. Influence of early mobilization program on pain, self-reported and performance based functional measures following total knee replacement. J Clin Orthop Trauma, 2019;10(2): 340-344.
• 20. Dehghani A, Hajibagheri A, Azizi-Fini. I, et al. Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: A randomised clinical trial. BMJ Support Palliat Care. 2020
• 21. Çaparlar Özhan C, Dönmez A. What is Scientific Research and How Can it be Done?, Turk Anaesthesiol Reanim, 2016;44: 212-8.
• 22. Price DD, McGrath PA., Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 1983;17(1):45-56.
• 23. Karaman S, Arici S, Dogru S, et al. Validation of the Turkish version of the quality of recovery-40 questionnaire. Health Qual of Life Outcomes, 2014; 12(1):1-6.
• 24. Carmichael JC, Keller DS, Baldini G, et.al. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American society of colon and rectal surgeons and society of American gastrointestinal and endoscopic surgeons. Dis Colon Rectum 2017;60(8):761e84.
• 25. Gümüs, K. (2021). The effects of preoperative and postoperative anxiety on the quality of recovery in patients undergoing abdominal surgery. Journal of PeriAnesthesia Nursing, 36(2), 174-178.
• 26. Özmen T Investigation of postoperative recovery conditions of patients undergoing surgical intervention, Ege University, Institute of Health Sciences, Department of Surgical Nursing, İzmir, 2020.
• 27. Dolgun E, Meryem YVG, Arzu A, et. al. The investigation of mobilization times of patients after surgery. Asian Pacific Journal of Health Science, 2017;4(1):71-75.
• 28. Hu Y, McArthur A, Yu Z. Early postoperative mobilization in patients undergoing abdominal surgery: a best practice implementation project. JBI Evidence Synthesis, 2019;17(12), 2591-2611.
• 29. Juita J, Yona S, Maria R. The benefits of early mobilization on post-abdominal surgery: a review of literature. Jurnal Ilmiah Ilmu Keperawatan Indonesia, 2023;13(01), 21-33.
• 30. Fukushima T, Adachi T, Hanada M, et al. Role of early mobilization on the clinical course of patients who underwent pancreaticoduodenectomy: A retrospective cohort study. Tohoku Journal of Experimental Medicine. 2021;254(4):287–94.
• 31. Siswoyo CYP, Murtaqib, KRMN. Effect of early mobilization on the change of pain level in clients with post appendectomy at Mawar Surgical Room of Baladhika Husada Hospital Jember Regency. Hospital, 2015;13(2):592-595.
• 32. Svensson-Raskh A, Nygren-Bonnier M, Olsén MF, Schandl A, Ståhle A. Mobilization immediately after elective abdominal surgery : respiratory effects and patients´ and healthcare professionals´ experiences. PQDT - Global. 2021. 94
• 33. Yolcu S, Akın S, Durna Z. Ameliyat sonrası dönemde hastaların hareket düzeyleri ve hareket düzeyleri ile ilişkili faktörlerin değerlendirilmesi. Hemşirelikte Eğitim ve Araştırma Dergisi, 2016;13(2), 129-138.
• 34. Yilmaz K, Yazici G. Koronavirüs pandemi sürecinde cerrahi sonrası hızlandırılmış iyileşme protokolleri ve hemşirelik yaklaşımları. Türk Hemşireler Derneği Dergisi, 2021;2(2), 65-77.
• 35. Başar, S.N. The Effect of Early Mobilization in Laparoscopic Cholecystectomy on Abdominal Pain and Comfort Level of the Patient, Atatürk University, Institute of Health Sciences, Master Thesis, Erzurum,2020.
• 36. Guerra ML, Singh PJ, Taylor NF. Early mobilization of patients who have had a hip or knee joint replacement reduces length of stay in hospital: a systematic review. Clin Rehabil, 2015; 29 (9), 844-854.
• 37. Devrez, N. Impacts of Early Mobilization and Spongostan-Supported Dressing on Bleeding, Pain and Urination among Coronary Angioplasty Patients, Hacettepe University, Institute of Health Sciences, Internal Medicine Nursing Program, PhD Thesis, Ankara.2015
• 38. Çandır G. The effect of early mobilization status onthe comfort level of patients after abdominal surgery, Hasan Kalyoncu University, Graduate School of Education, Gaziantep,2021.
• 39. Dictionary of Words of Western Origin in Turkish. Turkish Language Institution, Ankara, 2017. https://www.tdk.gov.tr/
• 40. Güner A, Karakoç KA. Comfort level and factor affecting comfort level of patients who had surgery for lung cancer, OTJHS, 2021;6(2):155-162.
• 41. Aydıngülü N, Arslan S. Comfort levels of patients at early postoperative period, J KSU Faculty of Med, 2021;16(3):401-406.
• 42. Das B, Saha S, Kabir F, et.al. Effect of graded early mobilization on psychomotor status and length of ıntensive care unit stay in mechanically ventilated patients, Indian J Crit Care Med, 2021;25(4): 416, 43. Akkaya BS. Investigation of the effects of ambulation periods on patient results, anxiety and depression of patients who had open abdominal surgery, Kütahya University of Health Sciences, Graduate School of Education, Master Thesis, Kütahya, 2020
• 44. Lapa TY, Korkmaz NH. Effect of physical activity levels on negative and positive affect comparison to the gender: Sample of Akdeniz and Uludağ Universities, J. Hum. Sci, 2017;14(4):3177-3187.
• 45. Kanejima Y, Shimogai T, Kitamura M, et.al. Effect of early mobilization on physical function in patients after cardiac surgery: a systematic review and meta-analysis. Int. J. Environ. Res. Public Health, 2020;17(19): 7091,
• 46. Watanabe S, Liu K, Morita Y, Kanaya T, Naito Y, Suzuki S, Hasegawa Y: Effects of mobilization among critically Ill patients in the ıntensive care unit: A Single-center Retrospective Study, JARM ,2022;(7): 20220013, 47. Vermişli S, Çam K. The efficacy of early mobilization after urologic radical surgery, Bull Urooncol, 2015;14: 324-326.
• 48. Lee TG, Kang SB, Kim DW, et. al. Comparison of early mobilization and diet rehabilitation program with conventional care after laparoscopic colon surgery: a prospective randomized controlled trial. Dis Colon Rectum, 2011;54(1):21-28.
• 49. Uğurlu AK., Şahin SK, Seçginli S. The effect of standing up early in the first 24 hours after surgery on rapid improvement: systematic review. Turk Clin J Nurs Sciences, 2017;9(4):280-288. 50. Zang K, Chen B, Wang M, et. al. The effect of early mobilization in critically ill patients: a meta‐analysis. Nurs Crit Care, 2020;25(6): 360-367,
• 51. Aksoy A, Yılmaz VD. A new approach to evidence based practices in gynecological surgery: ERAS Protocol and Nursing. Turk Clin J Nurs Sciences, 2018;10(1): 49-58.
• 52. Nechay T, Titkova S, Tyagunov A, et. al. Modified enhanced recovery after surgery protocol in patients with acute cholecystitis: efficacy, safety and feasibility. Multicenter randomized control study. Updates Surg, 2021;73(4):1407-1417.
• 53. Aquim EE., Bernardo WM, Buzzini RF, et. al. Brazilian guidelines for early mobilization in intensive care unit. Rev Bras Ter Intensiva. 2019;31(4):434-443.