Author:
Thörn Rose-Marie W.,Stepniewski Jan,Hjelmqvist Hans,Forsberg Anette,Ahlstrand Rebecca,Ljungqvist Olle
Abstract
Abstract
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.
Funder
Örebro University Hospital Research Foundation
Research Committee of Örebro County Council
Örebro University
Publisher
Springer Science and Business Media LLC
Cited by
12 articles.
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