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Original communication| Volume 105, ISSUE 1, P46-50, January 1989

Fatigue and cardiac and endocrine metabolic response to exercise after abdominal surgery

  • T. Christensen
    Correspondence
    Reprint requests: T. Christensen, MD, Sankt Knudsvej 23 B, 1903, Frederiksberg C, Denmark.
    Affiliations
    From the Departments of Surgical Gastroenterology and Medicine TTA, Rigshospitalet, Denmark

    From the Department of Surgical Gastroenterology F, Bispebjerg Hospital, Copenhagen, Denmark

    From the Department of Medical Physiology B, University of Copenhagen, Copenhagen, Denmark

    From the Department of Medicine F, Herlev Hospital, Copenhagen, Denmark

    From the Department of Surgical Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
    Search for articles by this author
  • J.G. Stage
    Affiliations
    From the Departments of Surgical Gastroenterology and Medicine TTA, Rigshospitalet, Denmark

    From the Department of Surgical Gastroenterology F, Bispebjerg Hospital, Copenhagen, Denmark

    From the Department of Medical Physiology B, University of Copenhagen, Copenhagen, Denmark

    From the Department of Medicine F, Herlev Hospital, Copenhagen, Denmark

    From the Department of Surgical Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
    Search for articles by this author
  • H. Galbo
    Affiliations
    From the Departments of Surgical Gastroenterology and Medicine TTA, Rigshospitalet, Denmark

    From the Department of Surgical Gastroenterology F, Bispebjerg Hospital, Copenhagen, Denmark

    From the Department of Medical Physiology B, University of Copenhagen, Copenhagen, Denmark

    From the Department of Medicine F, Herlev Hospital, Copenhagen, Denmark

    From the Department of Surgical Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
    Search for articles by this author
  • N.J. Christensen
    Affiliations
    From the Departments of Surgical Gastroenterology and Medicine TTA, Rigshospitalet, Denmark

    From the Department of Surgical Gastroenterology F, Bispebjerg Hospital, Copenhagen, Denmark

    From the Department of Medical Physiology B, University of Copenhagen, Copenhagen, Denmark

    From the Department of Medicine F, Herlev Hospital, Copenhagen, Denmark

    From the Department of Surgical Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
    Search for articles by this author
  • H. Kehlet
    Affiliations
    From the Departments of Surgical Gastroenterology and Medicine TTA, Rigshospitalet, Denmark

    From the Department of Surgical Gastroenterology F, Bispebjerg Hospital, Copenhagen, Denmark

    From the Department of Medical Physiology B, University of Copenhagen, Copenhagen, Denmark

    From the Department of Medicine F, Herlev Hospital, Copenhagen, Denmark

    From the Department of Surgical Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
    Search for articles by this author
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      Abstract

      Subjective feeling of fatigue was quantified before and 20 days after elective uncomplicated abdominal surgery in 16 otherwise-healthy patients and compared with changes in heart rate and various hormonal and substrate responses to a 10-minute bicycle exercise (65% of preoperative maximal work capacity) preoperatively and postoperatively. Postoperatively, fatigue increased (p < 0.001) from 3.0 ± 0.5 to 5.3 ± 0.5 arbitrary units (mean ± SEM). Heart rate, plasma catecholamines, and serum growth hormone, lactate, alanine, and glycerol values always increased, whereas serum insulin values decreased in response to exercise (p < 0.01). During exercise, only heart rate (p < 0.01) and lactate (p < 0.05) values were higher postoperatively compared with preoperatively. Increase in fatigue postoperatively correlated significantly to increase in heart rate (p < 0.01) and correlated positively, but not significantly, to increase in plasma levels of noradrenaline (p = 0.08), growth hormone (p = 0.09), and alanine (p = 0.08) during exercise, but not to increase in serum lactate values (p > 0.8). Thus, after uncomplicated surgery, there was increased fatigue and amplified metabolic and cardiovascular response to a given absolute work load. These findings are similar to those observed during detraining and suggest a therapeutic role of exercise in the treatment of postoperative fatigue.
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