Abstract

A short review of studies on postoperative fatigue and convalescence is given. From the limited data available, it is concluded that even otherwise uncomplicated abdominal surgery is followed by a pronounced increased feeling of fatigue in about one third of the patients, extending at least throughout the first postoperative month. Development of postoperative fatigue is unpredictable from preoperative assessment of various nutritional parameters, age, sex, and duration of surgery. In contrast, postoperative deterioration in nutritional status correlates to postoperative fatigue. Furthermore, during postoperative convalescence a decline in physical condition with impaired adaptability of heart rate to submaximal work loads has been demonstrated as well as an increased pulse rate during orthostatic stress in patients complaining of fatigue. Muscle function is decreased postoperatively, but further data are needed to evaluate the underlying mechanisms. Existing data on physical performance and subjective feeling of fatigue in late postoperative convalescence do not allow any conclusion as to whether choice of anesthetics, endocrine-metabolic response to surgery, immobilization, pain, psychological factors, or impaired nutritional intake, is the most important factor(s) in the pathogenesis of postoperative fatigue.