Physiotherapy in the perioperative period

Best Pract Res Clin Anaesthesiol. 2010 Jun;24(2):283-9. doi: 10.1016/j.bpa.2010.02.003.


Surgery and general anaesthesia have direct effects on the respiratory system depending on the organ/system involved and modality of delivery, potentially leading to postoperative pulmonary complications that increase hospital morbidity, prolong hospital stay and add to health-care costs. Postoperative complications have been reported to be as high as 30% for thoracotomy and lung resection in patients with chronic obstructive pulmonary disease. Most of the complications are due to respiratory muscle dysfunction and surgery-related changes in chest wall mechanics. In general, preoperative optimisation of medical therapy combined with physiotherapy and early extubation and mobilisation may improve clinical outcomes in high-risk surgeries, including upper abdominal and thoracic surgery in patients with severe emphysema. Evidence from randomised controlled trials or meta-analyses is limited and most of the recommendations on perioperative physiotherapy come from either uncontrolled or non-randomised trials or from observational studies and expert opinion.

Publication types

  • Review

MeSH terms

  • Anesthesia, General / adverse effects
  • Anesthesia, General / methods
  • Health Care Costs
  • Humans
  • Perioperative Care / methods*
  • Physical Therapy Modalities*
  • Postoperative Complications / prevention & control*
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / prevention & control
  • Respiratory Mechanics