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Bilateral Flank Compression Maneuver for Reducing Pain on Coughing after Abdominal Surgery: A Prospective Study

29 Pages Posted: 10 Dec 2018

See all articles by Hayato Shimoyama

Hayato Shimoyama

Kyorin University - Department of Surgery

Masanori Sugiyama

Kyorin University - Department of Surgery

Yutaka Suzuki

Kyorin University - Department of Surgery

Koji Teruya

Kyorin University

Yoshikazu Hashimoto

Kyorin University - Department of Surgery

Gen Nagao

Kyorin University - Department of Surgery

Tadahiko Masaki

Kyorin University - Department of Surgery

Toshiyuki Mori

Kyorin University - Department of Surgery

Nobutsugu Abe

Kyorin University - Department of Surgery

More...

Abstract

Background: Though analgesic methods have advanced markedly, relief of coughing pain after abdominal surgery remains a challenge. Coughing pain causes postoperative respiratory complications by diminishing sputum discharge. There are as yet no effective strategies for pain on coughing. We devised the BFC (bilateral flank compression) maneuver, in which the flanks are compressed medially using both hands.  

Methods: We prospectively investigated whether the BFC maneuver relieved pain on coughing after abdominal surgery. We examined the relationships of patient characteristics and operative factors with the efficacy of the BFC maneuver. We investigated 514 patients who underwent gastroenterological operations at Kyorin University between March 2016 and March 2017. We evaluated postoperative pain on coughing with and without the BFC maneuver using the Prince Henry pain scale.  

Findings: On each day throughout the first seven postoperative days, the BFC maneuver relieved coughing pain significantly, especially on POD1; (with vs. without BFC pain scores had mean values of 0·98 vs. 1·63 points, p<·0001). The proportion of patients free of coughing pain was also significantly higher with than without the BFC maneuver on each day of the study period, with the most marked difference on POD7 (52% vs. 17%, p<·0001). In subgroup analyses of patient characteristics and operative factors, the BFC maneuver relieved coughing pain significantly, along with improvements on each day in several variables.  

Interpretation: The BFC maneuver relieves coughing pain after abdominal surgery and may contribute to prevention of postoperative pulmonary complications.  

Funding: This study received no funding outside of Kyorin University School of Medicine.

Declaration of Interest: The authors have no competing interests to declare.

Ethical Approval: The study protocol was approved by the institutional review board of Kyorin University School of Medicine, and the consent of all participants was obtained based on the return of the questionnaires.

Suggested Citation

Shimoyama, Hayato and Sugiyama, Masanori and Suzuki, Yutaka and Teruya, Koji and Hashimoto, Yoshikazu and Nagao, Gen and Masaki, Tadahiko and Mori, Toshiyuki and Abe, Nobutsugu, Bilateral Flank Compression Maneuver for Reducing Pain on Coughing after Abdominal Surgery: A Prospective Study (January 12, 2018). Available at SSRN: https://ssrn.com/abstract=3296662

Hayato Shimoyama (Contact Author)

Kyorin University - Department of Surgery ( email )

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Masanori Sugiyama

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Yutaka Suzuki

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Koji Teruya

Kyorin University

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Yoshikazu Hashimoto

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Gen Nagao

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Tadahiko Masaki

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Toshiyuki Mori

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

Nobutsugu Abe

Kyorin University - Department of Surgery

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

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