Skip to main content
NCBI home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1997 Dec;90(12):661–664. doi: 10.1177/014107689709001207

A theory of postoperative fatigue.

P Salmon 1, G M Hall 1
PMCID: PMC1296734  PMID: 9496290

Abstract

The concept of fatigue has entered medicine from other disciplines in which the term refers to weakening of a material by demands put upon it. Its application to the behavioural and subjective changes that characterize postoperative convalescence has led to the assumption that these changes reflect the physiological and metabolic consequences of surgery. Because evidence does not support this view, we outline a new theory in which postoperative fatigue is the product of physiological, psychological and cultural factors. This theory leads to novel predictions that can be tested in future clinical research. Of particular interest will be the evaluation of systematic attempts to change patient and staff expectations about postoperative convalescence.

Full text

PDF
661

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALLAM M. W., MARTIN J. E. A survey of some physiological responses of domestic animals during the immediate postsurgical period. Ann N Y Acad Sci. 1958 Sep 10;73(2):438–443. doi: 10.1111/j.1749-6632.1959.tb40816.x. [DOI] [PubMed] [Google Scholar]
  2. Aarons H., Forester A., Hall G., Salmon P. Fatigue after major joint arthroplasty: relationship to preoperative fatigue and postoperative emotional state. J Psychosom Res. 1996 Sep;41(3):225–233. doi: 10.1016/0022-3999(95)00646-x. [DOI] [PubMed] [Google Scholar]
  3. BEECHER H. K. Relationship of significance of wound to pain experienced. J Am Med Assoc. 1956 Aug 25;161(17):1609–1613. doi: 10.1001/jama.1956.02970170005002. [DOI] [PubMed] [Google Scholar]
  4. Bardram L., Funch-Jensen P., Jensen P., Crawford M. E., Kehlet H. Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisation. Lancet. 1995 Mar 25;345(8952):763–764. doi: 10.1016/s0140-6736(95)90643-6. [DOI] [PubMed] [Google Scholar]
  5. Christensen T., Hjortsø N. C., Mortensen E., Riis-Hansen M., Kehlet H. Fatigue and anxiety in surgical patients. Acta Psychiatr Scand. 1986 Jan;73(1):76–79. doi: 10.1111/j.1600-0447.1986.tb02670.x. [DOI] [PubMed] [Google Scholar]
  6. Christensen T. Postoperative fatigue. Dan Med Bull. 1995 Sep;42(4):314–322. [PubMed] [Google Scholar]
  7. Coulter A., McPherson K. Waiting times and duration of hospital stay for common surgical operations: trends over time. Community Med. 1987 Aug;9(3):247–253. doi: 10.1093/oxfordjournals.pubmed.a043934. [DOI] [PubMed] [Google Scholar]
  8. Felig P., Cherif A., Minagawa A., Wahren J. Hypoglycemia during prolonged exercise in normal men. N Engl J Med. 1982 Apr 15;306(15):895–900. doi: 10.1056/NEJM198204153061503. [DOI] [PubMed] [Google Scholar]
  9. Fink P. Surgery and medical treatment in persistent somatizing patients. J Psychosom Res. 1992 Jul;36(5):439–447. doi: 10.1016/0022-3999(92)90004-l. [DOI] [PubMed] [Google Scholar]
  10. Flood A. B., Lorence D. P., Ding J., McPherson K., Black N. A. The role of expectations in patients' reports of post-operative outcomes and improvement following therapy. Med Care. 1993 Nov;31(11):1043–1056. doi: 10.1097/00005650-199311000-00006. [DOI] [PubMed] [Google Scholar]
  11. Hickok J. T., Morrow G. R., McDonald S., Bellg A. J. Frequency and correlates of fatigue in lung cancer patients receiving radiation therapy: implications for management. J Pain Symptom Manage. 1996 Jun;11(6):370–377. doi: 10.1016/0885-3924(96)00008-5. [DOI] [PubMed] [Google Scholar]
  12. Ho K. H., Hashish I., Salmon P., Freeman R., Harvey W. Reduction of post-operative swelling by a placebo effect. J Psychosom Res. 1988;32(2):197–205. doi: 10.1016/0022-3999(88)90055-4. [DOI] [PubMed] [Google Scholar]
  13. Hotopf M. H., Wessely S. Viruses, neurosis and fatigue. J Psychosom Res. 1994 Aug;38(6):499–514. doi: 10.1016/0022-3999(94)90047-7. [DOI] [PubMed] [Google Scholar]
  14. Jensen M. B., Hessov I. Randomization to nutritional intervention at home did not improve postoperative function, fatigue or well-being. Br J Surg. 1997 Jan;84(1):113–118. [PubMed] [Google Scholar]
  15. Manyande A., Berg S., Gettins D., Stanford S. C., Mazhero S., Marks D. F., Salmon P. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosom Med. 1995 Mar-Apr;57(2):177–182. doi: 10.1097/00006842-199503000-00010. [DOI] [PubMed] [Google Scholar]
  16. Pick B., Molloy A., Hinds C., Pearce S., Salmon P. Post-operative fatigue following coronary artery bypass surgery: relationship to emotional state and to the catecholamine response to surgery. J Psychosom Res. 1994 Aug;38(6):599–607. doi: 10.1016/0022-3999(94)90057-4. [DOI] [PubMed] [Google Scholar]
  17. Rose E. A., King T. C. Understanding postoperative fatigue. Surg Gynecol Obstet. 1978 Jul;147(1):97–102. [PubMed] [Google Scholar]
  18. Schroeder D., Hill G. L. Postoperative fatigue: a prospective physiological study of patients undergoing major abdominal surgery. Aust N Z J Surg. 1991 Oct;61(10):774–779. [PubMed] [Google Scholar]
  19. Schroeder D., Hill G. L. Predicting postoperative fatigue: importance of preoperative factors. World J Surg. 1993 Mar-Apr;17(2):226–231. doi: 10.1007/BF01658931. [DOI] [PubMed] [Google Scholar]
  20. Schulze S., Møller I. W., Bang U., Rye B., Kehlet H. Effect of combined prednisolone, epidural analgesia and indomethacin on pain, systemic response and convalescence after cholecystectomy. Acta Chir Scand. 1990 Mar;156(3):203–209. [PubMed] [Google Scholar]
  21. Schulze S., Sommer P., Bigler D., Honnens M., Shenkin A., Cruickshank A. M., Bukhave K., Kehlet H. Effect of combined prednisolone, epidural analgesia, and indomethacin on the systemic response after colonic surgery. Arch Surg. 1992 Mar;127(3):325–331. doi: 10.1001/archsurg.1992.01420030095018. [DOI] [PubMed] [Google Scholar]
  22. Sharpe M., Hawton K., Simkin S., Surawy C., Hackmann A., Klimes I., Peto T., Warrell D., Seagroatt V. Cognitive behaviour therapy for the chronic fatigue syndrome: a randomized controlled trial. BMJ. 1996 Jan 6;312(7022):22–26. doi: 10.1136/bmj.312.7022.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Thayer R. E. Energy, tiredness, and tension effects of a sugar snack versus moderate exercise. J Pers Soc Psychol. 1987 Jan;52(1):119–125. doi: 10.1037//0022-3514.52.1.119. [DOI] [PubMed] [Google Scholar]
  24. Ware N. C., Kleinman A. Culture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome. Psychosom Med. 1992 Sep-Oct;54(5):546–560. doi: 10.1097/00006842-199209000-00003. [DOI] [PubMed] [Google Scholar]
  25. Wessely S., Powell R. Fatigue syndromes: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders. J Neurol Neurosurg Psychiatry. 1989 Aug;52(8):940–948. doi: 10.1136/jnnp.52.8.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Wilson A., Hickie I., Lloyd A., Hadzi-Pavlovic D., Boughton C., Dwyer J., Wakefield D. Longitudinal study of outcome of chronic fatigue syndrome. BMJ. 1994 Mar 19;308(6931):756–759. doi: 10.1136/bmj.308.6931.756. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Zeiderman M. R., Welchew E. A., Clark R. G. Influence of epidural analgesia upon postoperative fatigue. Br J Surg. 1991 Dec;78(12):1457–1460. doi: 10.1002/bjs.1800781217. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES