A PROSPECTIVE STUDY TO ASSESS EFFECT OF INCENTIVE SPIROMETRY ON POST OPERATIVE PULMONARY COMPLICATIONS IN PATIENTS UNDERGOING ELECTIVE MAJOR ABDOMINAL SURGERIES

Background: Postoperative pulmonary complications (PPCs) remain a common cause of morbidity after major abdominalsurgery. Preoperative incentive spirometry is widely used to improve respiratory performance, though its effect on PPCincidence in Indian tertiary-care settings is less well characterised. This study assessed the effect of preoperative incentivespirometry on PPCs and postoperative spirometric performance in patients undergoing elective major abdominal surgery.Materials and Methods: This prospective observational study enrolled 100 patients aged >16 years undergoing electivemajor abdominal surgery lasting >2 hours at a tertiary care hospital. Patients received standardised preoperative incentivespirometry training, with performance assessed preoperatively, on postoperative days 2 and 3, and at discharge. PPCincidence and its association with surgical and patient-related risk factors were analysed using Chi-square/Fisher's exacttests, with p<0.05 considered significant. Results: Mean age was 42.7 ± 17.6 years, with female predominance (67%); 58%underwent laparoscopic and 42% open surgery. Spirometry performance declined from 98% adequate preoperatively to 33%on POD 2 (mean volume 593 ± 314 mL, p<0.001), recovering to 96% by discharge. PPCs occurred in 18% of patients —atelectasis (12%), pneumonia (6%) — significantly more frequent after open (38.1%) than laparoscopic (3.4%) surgery(p<0.001). Age >60 years, BMI ≥30 kg/m², smoking, COPD, open surgery, and operative duration >3 hours weresignificantly associated with PPCs. Conclusion: Preoperative incentive spirometry training was associated with a favourablepostoperative respiratory recovery trajectory. Open surgery, prolonged operative duration, smoking, and obesity were keypredictors of PPCs, supporting targeted perioperative respiratory care in high-risk patients.