The Association between Selected Demographic Data, Postoperative Pain, Anxiety, Complications, Pulmonary Complications and Physiological Recovery of Patients after Major Abdominal Surgery in Critical Stage

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Somkid Thongdee
Pongsri Srimoragot
Phornlert Chatrkaw


Purpose: To explore selected factors associated to physiological recovery (the Acute Physiology and Chronic Health Evaluation II: APACHE II) of patients after major abdominal surgery in critical stage.

Design: Descriptive design.

Methods: The sample group consisted of 86 patients undergoing major abdominal surgery (GI system and accessory organs) who had been admitted to the surgical intensive care unit at Chulalongkorn Memorial Hospital, Thailand, from August to December of 2009. Data collection was performed by using demographic assessment form, the numeric rating pain scale, pulmonary complication evaluation form, numeric rating anxiety scale, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) after immediate surgery. Descriptive statistics and chi-square test were used in data analysis.

Main findings: The result showed that majority of patients were male, age range from 18-87 years old (average 62.13±16.45). Seventy one percent of them had co-morbidity include HT, DM, IHD, etc. The pain score averaged 5.08±2.89 to 3.78±2.71 and anxiety score averaged 2.69±2.83 to 2.24±2.88 from 10 scores. 2.3 percent of them found pulmonary complications and 23.3 percent of them found postoperative complications. Most common postoperative complications were HT, arrhythmia, Acute MI, Infection, etc. There were significant association between age, pulmonary complications, postoperative complications and physiological recovery: APACHE II of patients after major abdominal surgery in critical stage (p< .01, .05, and .01, respectively).

Conclusion and recommendations: Awareness regarding age, pulmonary complications, and postoperative complications should be promoted to improve the physiological recovery of patients during the immediate recovery phase.

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Thongdee, S., Srimoragot, P., & Chatrkaw, P. (2012). The Association between Selected Demographic Data, Postoperative Pain, Anxiety, Complications, Pulmonary Complications and Physiological Recovery of Patients after Major Abdominal Surgery in Critical Stage. Nursing Science Journal of Thailand, 29(2), 129–139. Retrieved from
Research Papers


Long BC, Phipps WJ, Cassmeyer VL. Medical surgical nursing: a nursing process approach. St. Louis: Mosby; 1993.

Kaplow R, Hardin SR. Critical care nursing: synergy for optimal outcomes. Boston: Jones and Bartlett; 2007.

Walsh TS, Pollok AJ. Principles of fluid and electrolyte balance in surgical Patients. In: Garden OJ, editors. Priciple & practice of surgery. 5th ed. Philadelphia: Elsevier; 2007. P.13-23.

Allvin R, Berg K, Idvall E, Nilsson U. Postoperative recovery: a concept analysis. J Adv Nurs 2007; 57(5): 555-8.

Strand K, Walther MS, Reinikainen M, Ala- Kokko T, Nolin T, Martner J, et al. Variations in the length of stay of intensive care unit nonsurvivors in three Scandinavia coumtry. Critical care 2010; 14(R175): 1-8.

McNicol L, Story AD, Leslie K, Myles SP, Fink M, Shelton CA, et al. Post operative complications and mortality in older patients having non-cardiac surgery at three Melbourne teaching hospitals. Medl J Aust 2007; 186(7): 447-52.

Groot W, Brink HM. The health effects of education. Econ. Educ. Rev. 2007; 26 :186- 200.

Alspach GJ. Core curriculum for critical nursing. 6th ed. St. Louis: Saunders Elsevier; 2006.

ธารา ตริตระการ, วรรณา ศรีโรจนกุล, เพ็ญแข เกตุมาน, ประวิทย์ อัครเสรีนนท์, วิมลลักษณ์ สนั่นศิลป์, สุรีรัตน์ ชีววัฒนาและคณะ. หนังสือ ประกอบการประชุมเชิงปฏิบัติการ Post operative pain management. กรุงเทพฯ: ภาควิสัญญีวิทยา คณะแพทยศาสตร์ศิริราชพยาบาล; 2544.

Pavlin JD, Chen C, Penaloza DA, Polissar LN, Buckley PF. Pain as a factor complication recovery and discharge after ambulatory surgery. Anesth Analg 2002; 95: 627-34.

Kanat F, Golcuk A, Teke T, Golcuk M. Risk factors for post operative pulmonary complication in upper abdominal surgery. ANZ J. Surg. 2007; 77: 135-41.

Brooks-Brunn JA. Predictors of postoperative pulmonary complications following abdominal surgery. Chest 1997; 111: 564-71.

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

Seers K. Pain. In: Alexander MF, editors. Nursing practice: hospital and home the adult. Edinburgh: Churchill Livingstone; 1999. P.615-35.

Browing L, Denehy L, Scholes RL. The quantity of early upright mobilization performed following upper abdominal surgery is low: an observational study. Australian Journal of Physiotherapy 2007; 53: 47-52.

Gaberson KB. The effect of humorous distraction on preoperation anxiety. AORN Journal 1991; 62(5): 784-8, 790-1.

Knaus WA, Daper EA., Wager DP, Zimmeman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985; 13: 818-29.

Hariharan S, Moseley HSL. Kumar A.Y. Outcome evalution in a surgical intensive care unit in Barbados. Anaesth. 2002; 57: 434-41.

มลธิรา อุดชุมพิสัย. ปัจจัยที่มีอิทธิพลต่อการใช้ เครื่องช่วยหายใจเป็นเวลานานในผู้ป่วยวิกฤตทาง อายุรกรรม. (วิทยานิพนธ์) กรุงเทพฯ: มหาวิทยาลัยมหิดล; 2553. 56 หน้า.

Rudra A, Das S. Postoperative pulmonary complications. Indian J Anaesth 2006; 50(2): 89-98.

Kaempf G, Goralski VA. Monitoring postoperative patients. RN 1996 Jury: 31-4.

Brathwaite D, Weissman C. The new onset of aterial arrhythmias folling major Non cardiothoracic surgery is associated with increased mortality. Chest 1998; 114(2):


ปิลันธน์ ลิขิตกำจร. ความสัมพันธ์ระหว่างการ นอนหลับ ความปวด และผลลัพธ์ของผู้ป่วยหลัง ผ่าตัดช่องท้อง. (วิทยานิพนธ์) สงขลา: มหาวิทยาลัยสงขลานครินทร์; 2546. 72 หน้า.

ปิ่น ศรีประจิตติชัย. การระงับปวดหลังผ่าตัด. ใน: วรรณา สมบูรณ์วิบูรณ์, เทวารักษ์ วีระวัฒกานนท์, ปวีณา บุญบูรพงศ์ และสมรัตน์ จารุลักษณานันท์, บรรณาธิการ. วิสัญญีวิทยาพื้นฐาน. กรุงเทพฯ: เท็กซ์ แอนด์ เจอร์นัล พับลิเคชั่น จำกัด: 2547. หน้า 188-94.

Clark S, Fontaine DK, Simpson T. Recognition, assessment, and treatment of anxiety in the critical care setting. Crit Care Nurse 1994; 14(4): 2-14.