Effect of prolonged oxygen inhalation after total hip arthroplasty on early postoperative rehabilitation in elderly patients_West China Medical Journal

Authors：

LI Jianxia ,  NING Ning , LI Peifang , HOU Xiaoling , CHEN Shanyu

Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

NING Ning, Email: gkningning@126.com

Keywords：

Elderly patients; Total hip arthroplasty; Oxygen inhalation; Pain; Fatigue

DOI：

10.7507/1002-0179.201904060

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Objective To assess the effect of prolonged oxygen inhalation after total hip arthroplasty (THA) on early postoperative rehabilitation in elderly patients.Methods Patients who underwent primary unilateral THA from June to December 2018 were divided into a conventional oxygen inhalation group (control group) and a prolonged oxygen inhalation group (trial group) according to a random number table. The control group received oxygen inhalation via a single nasal catheter from their return to the ward after surgery until 08:00 a.m. on the first day postoperatively. In addition to routine oxygen inhalation, the trial group received oxygen inhalation during the rehabilitation exercise in bed and before half an hour of floor activities on the first and second day after operation. Oxygen saturation, heart rate, respiratory rate, blood pressure, pain, fatigue score, hip mobility and Pittsburgh Sleep Quality Index (PSQI) scores were recorded and analyzed at 24 and 48 hours after surgery.Results A total of 60 patients were included finally, 30 patients in each group. At 24 and 48 h after surgery, the differences were statistically significant in the respiratory rate [(20.30±1.20) vs. (21.40±1.04) breaths per minute, (18.87±1.14) vs. (22.03±0.85) breaths per minute], oxygen saturation [(94.70±2.34)% vs. (90.60±0.73)%, (96.40±1.81)% vs. (91.20±0.85)%］, abduction angles of hip joint [(33.50±5.44) vs. (29.31±5.30)°, (38.67±2.60) vs. (33.00±4.84)°], pain scores (3.03±1.27 vs. 5.07±1.14, 1.43±0.97 vs. 3.60±1.13) and fatigue scores (4.17±1.34 vs. 8.20±0.61, 3.23±1.38 vs. 7.43±1.19) between the trial group and control group (P<0.05). PSQI scores (2.20±0.76 vs. 3.97±0.76) on the first day after surgery, and hip flexion [(105.17±4.82) vs. (99.50±2.40)°] , heart rate [(72.86± 6.38) vs. (79.40±3.97) beats per minute], diastolic blood pressure [(71.43±10.24）vs. (77.57±4.59) mm Hg (1 mm Hg=0.133 kPa)] at 48 h after surgery in the trial group were better than the those in control group (P<0.05).Conclusion Compared with conventional oxygen inhalation, prolonged oxygen inhalation after THA in elderly patients can improve postoperative pain, fatigue, sleep and hip function.

Citation： LI Jianxia, NING Ning, LI Peifang, HOU Xiaoling, CHEN Shanyu. Effect of prolonged oxygen inhalation after total hip arthroplasty on early postoperative rehabilitation in elderly patients. West China Medical Journal, 2019, 34(11): 1302-1306. doi: 10.7507/1002-0179.201904060 Copy

1.	Stowers MD, Manuopangai L, Hill AG, et al. Enhanced recovery after surgery in elective hip and knee arthroplasty reduces length of hospital stay. ANZ J Surg, 2016, 86(6): 475-479.
2.	秦宏敏, 劉漢濤, 劉典鋒. 攀枝花市學齡前兒童無癥狀發育性髖關節發育不良的社區篩查及流行病學調查. 中國矯形外科雜志, 2018, 26(19): 1775-1777.
3.	Yue C, Kang P, Yang P, et al. Topical application of tranexamic acid in primary total hip arthroplasty: a randomized double-blind controlled trial. J Arthroplasty, 2014, 29(12): 2452-2456.
4.	Buhulaigah AA, Miran SA, Alwagdani MS, et al. Anemia in the elderly. Indo Am J Pharm Sci, 2018, 5(12): 16993-17000.
5.	王重陽, 吳偉乾, 田宗升, 等. 阻塞性睡眠呼吸暫停在關節置換術圍手術期中的管理. 中華肺部疾病雜志(電子版), 2016, 9(2): 218-220.
6.	趙崇法. 麻醉手術后低氧血癥的防治. 醫學綜述, 2009, 15(5): 769-771.
7.	Zhang S, Huang Q, Xie J, et al. Factors influencing postoperative length of stay in an enhanced recovery after surgery program for primary total knee arthroplasty. J Orthop Surg Res, 2018, 13(1): 29.
8.	Drew S, Judge A, Cohen R, et al. Enhanced recovery after surgery implementation in practice: an ethnographic study of services for hip and knee replacement. BMJ open, 2019, 9(3): e024431.
9.	Akbari H, Ghasemi M, Yegani T, et al. Million visual analogue scale questionnaire: validation of the persian version. Asian spine J, 2019, 13(2): 242-247.
10.	Manzar MD, BaHammam AS, Hameed UA, et al. Dimensionality of the pittsburgh sleep quality index: a systematic review. Health Qual Life Outcomes, 2018, 16(1): 89.
11.	Elings J, Hoogeboom TJ, van der Sluis G, et al. What preoperative patient-related factors predict inpatient recovery of physical functioning and length of stay after total hip arthroplasty? A systematic review. Clin Rehabil, 2015, 29(5): 477-492.
12.	張川蓉, 朱小舟, 任瑞芳, 等. 全身麻醉腹部手術后低氧血癥 52 例的原因分析及護理. 護理與康復, 2012, 11(4): 339-340.
13.	高福強, 郭萬首, 孫偉, 等. 人工關節置換術后低氧血癥的發生機制與影響因素分析. 中華醫學雜, 2014, 94(9): 655-659.
14.	隋紅艷, 朱英杰, 劉佳美. 氧驅動霧化在心臟病術后患者預防低氧血癥的療效探討. 中外醫療, 2015(33): 66-67.
15.	Zhang F, Zhang R, He L, et al. Effects of preoperative chronic hypoxemia on geriatrics outcomes after hip arthroplasty: a hospital-based retrospective analysis study. Medicine (Baltimore), 2017, 96(15): e6587.

1. Stowers MD, Manuopangai L, Hill AG, et al. Enhanced recovery after surgery in elective hip and knee arthroplasty reduces length of hospital stay. ANZ J Surg, 2016, 86(6): 475-479.
2. 秦宏敏, 劉漢濤, 劉典鋒. 攀枝花市學齡前兒童無癥狀發育性髖關節發育不良的社區篩查及流行病學調查. 中國矯形外科雜志, 2018, 26(19): 1775-1777.
3. Yue C, Kang P, Yang P, et al. Topical application of tranexamic acid in primary total hip arthroplasty: a randomized double-blind controlled trial. J Arthroplasty, 2014, 29(12): 2452-2456.
4. Buhulaigah AA, Miran SA, Alwagdani MS, et al. Anemia in the elderly. Indo Am J Pharm Sci, 2018, 5(12): 16993-17000.
5. 王重陽, 吳偉乾, 田宗升, 等. 阻塞性睡眠呼吸暫停在關節置換術圍手術期中的管理. 中華肺部疾病雜志(電子版), 2016, 9(2): 218-220.
6. 趙崇法. 麻醉手術后低氧血癥的防治. 醫學綜述, 2009, 15(5): 769-771.
7. Zhang S, Huang Q, Xie J, et al. Factors influencing postoperative length of stay in an enhanced recovery after surgery program for primary total knee arthroplasty. J Orthop Surg Res, 2018, 13(1): 29.
8. Drew S, Judge A, Cohen R, et al. Enhanced recovery after surgery implementation in practice: an ethnographic study of services for hip and knee replacement. BMJ open, 2019, 9(3): e024431.
9. Akbari H, Ghasemi M, Yegani T, et al. Million visual analogue scale questionnaire: validation of the persian version. Asian spine J, 2019, 13(2): 242-247.
10. Manzar MD, BaHammam AS, Hameed UA, et al. Dimensionality of the pittsburgh sleep quality index: a systematic review. Health Qual Life Outcomes, 2018, 16(1): 89.
11. Elings J, Hoogeboom TJ, van der Sluis G, et al. What preoperative patient-related factors predict inpatient recovery of physical functioning and length of stay after total hip arthroplasty? A systematic review. Clin Rehabil, 2015, 29(5): 477-492.
12. 張川蓉, 朱小舟, 任瑞芳, 等. 全身麻醉腹部手術后低氧血癥 52 例的原因分析及護理. 護理與康復, 2012, 11(4): 339-340.
13. 高福強, 郭萬首, 孫偉, 等. 人工關節置換術后低氧血癥的發生機制與影響因素分析. 中華醫學雜, 2014, 94(9): 655-659.
14. 隋紅艷, 朱英杰, 劉佳美. 氧驅動霧化在心臟病術后患者預防低氧血癥的療效探討. 中外醫療, 2015(33): 66-67.
15. Zhang F, Zhang R, He L, et al. Effects of preoperative chronic hypoxemia on geriatrics outcomes after hip arthroplasty: a hospital-based retrospective analysis study. Medicine (Baltimore), 2017, 96(15): e6587.

West China Medical Journal

Effect of prolonged oxygen inhalation after total hip arthroplasty on early postoperative rehabilitation in elderly patients

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