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Supervised Immediate Postoperative Mobilization After Elective Colorectal Surgery: A Feasibility Study
Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden.
Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Anesthesiology and Intensive Care.ORCID iD: 0000-0001-5294-8387
Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-6768-5740
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2022 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 46, no 1, p. 34-42Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Early mobilization is a significant part of the ERAS® Society guidelines, in which patients are recommended to spend 2 h out of bed on the day of surgery. However, it is not yet known how early patients can safely be mobilized after completion of colorectal surgery. The aim of this study was to evaluate the feasibility, and safety of providing almost immediate structured supervised mobilization starting 30 min post-surgery at the postoperative anesthesia care unit (PACU), and to describe reactions to this approach.

METHODS: This feasibility study includes 42 patients aged ≥18 years who received elective colorectal surgery at Örebro University Hospital. They underwent a structured mobilization performed by a specialized physiotherapist using a modified Surgical ICU Optimal Mobilization Score (SOMS). SOMS determines the level of mobilization at four levels from no activity to ambulating. Mobilization was considered successful at SOMS ≥ 2, corresponding to sitting on the edge of the bed as a proxy of sitting in a chair due to lack of space.

RESULTS: In all, 71% (n = 30) of the patients reached their highest level of mobilization between the second and third hour of arrival in the PACU. Before discharge to the ward, 43% (n = 18) could stand at the edge of the bed and 38% (n = 16) could ambulate. Symptoms that delayed advancement of mobilization were pain, somnolence, hypotension, nausea, and patient refusal. No serious adverse events occurred.

CONCLUSIONS: Supervised mobilization is feasible and can safely be initiated in the immediate postoperative care after colorectal surgery. Trial registration Clinical trials.gov identifier: NTC03357497.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 46, no 1, p. 34-42
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Surgery
Identifiers
URN: urn:nbn:se:oru:diva-95107DOI: 10.1007/s00268-021-06347-2ISI: 000708755200004PubMedID: 34668047Scopus ID: 2-s2.0-85117270625OAI: oai:DiVA.org:oru-95107DiVA, id: diva2:1604732
Note

Funding Agencies:

Örebro University

Research Committee of Örebro County Council and Örebro University Hospital Research Foundation, Sweden

Available from: 2021-10-21 Created: 2021-10-21 Last updated: 2022-01-04Bibliographically approved

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W. Thörn, Rose-MarieHjelmqvist, HansForsberg, AnetteAhlstrand, RebeccaLjungqvist, Olle

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