Objective of Study
Speedier convalescence, return to activity & improved health related quality of life (HrQoL) are indices of patient reported outcomes in laparoscopic cholecystectomy (LC). Improving patient reported outcomes by minimising multi-factorial post-operative pain & fatigue in LC demand a multi-pronged approach. Yoga improves HrQoL in many chronic fatigue & stress related inflammatory disorders. We studied the effect of yoga on the speed of convalescence after uncomplicated outpatient LC.
Methods and procedures
From January 2007 to June 2009, consecutive unselected lacto-vegetarian candidates for LC on index clinical presentation were evaluated for outpatient day care surgery to be enrolled with ethics & informed consent protocol. They were allocated to Control Group (those who had no formal training /practice of Yoga) & Study Group (those who had regular formal training /practice of Yoga). A standard anesthesia / antibiotic/ analgesia (Paracetamol 650 mgs.used SOS for any significant pain)/ surgery & discharge protocol was followed.
| Study End Point | Measuring Scale |
|---|---|
| HrQoL | 100-point; 36-items;8-subscale SF-36 generic measure |
| Nausea | 0-no nausea; 1-some; 2-moderate; 3-severe; 4-vomiting |
| Pain | no pain-0 & worst-100@100 point visual analog scale |
| Fatigue | 10-point Christensen fatigue scale; 1 = fit, 10 = fatigued |
| Prospective data collected pre-operatively (P0) & post-operatively on Day1 (D1), Day2 (D2), Day3 (D3), 1st week (W1), 2nd week (W2) & 3rd week (W3) | |
Results
The Study (49) & Control (73) groups were well matched for demographic, activity, co-morbidity and gallbladder inflammation parameters. There were no adverse events or failure to discharge from day care. Patient noncompliance led to withdrawal of 7 & 19 patients leaving 42 (study) & 54 (control) for analysis.
| Group | Nausea | Pain | Fatigue | ||||||
| Follow-up | D1 | D2 |
D3 |
D3 |
W1 | W3 |
D3 | W1 |
W3 |
| Control | 3.2 | 1.9 | 0.5 | 64 | 34 | 23 | 10 | 9 | 4.2 |
| Study | 1.7 | 0.6 | 0 | 47 | 09 | 09 | 6 | 3.6 | 1.4 |
| * | PF | RP | BP | GHP | VI | SF | RE | MH |
| P0 | 84(90) | 70(75) | 60(60) | 66(65) | 55(61) | 46(67) | 81(75) | 80(78) |
| W1 | 60(80) | 36(65) | 60(82) | 70(90) | 48(62) | 50(90) | 80(80) | 70(80) |
| W3 | 66(88) | 45(70) | 90(96) | 75(94) | 55(65) | 70(95) | 80(80) | 80(80) |
*PF-physical functioning; RP-role physical; BP-bodily pain; GHP-general health perception; VI-vitality; SF-social functioning; RE-role emotional; MH-mental health
Conclusion
Yoga practicing patients showed a speedier convalescence after LC. These effects need assessment with Yoga as a pre-operative intervention in randomized controlled trials on non-vegetarian population not familiar or not practicing Yoga.
Session: Poster
Program Number: P414