Medically reviewed by Oliver Eng, MD
Coughing after surgery is important for clearing the lungs and preventing pneumonia and other lung complications.
Although coughing doesn't seem like a big deal in your daily life, that may change after surgery. Coughing is not as easy when you are recovering after a procedure as it can be painful.
This article covers why it's important to cough after surgery, breathing exercises you can do, and ways to prevent complications.
Why Am I Coughing So Much After Surgery?
For some people, anesthesia can cause a dry, persistent cough after surgery. This is common and normally lasts only a day or two.
Coughing is your body’s natural way of getting rid of excess mucus in the lungs. If mucus lingers in the lungs too long, it can become infected.
Purpose of Coughing After Surgery
Coughing after surgery helps prevent pneumonia by helping you breathe deeply. It expands the lungs and clears secretions that may have built up when you were on a ventilator, intubated, or under anesthesia. Pneumonia can be life-threatening after surgery.
Many patients avoid coughing because it's so painful. But it's vital that you cough enough to prevent lung complications. Coughing clears the lungs of normal secretions, infectious material like pus, and foreign objects. It keeps the lungs open and expanded.
For patients who avoid coughing or are too weak to cough, it may be necessary to use suction to clear the lungs in the hospital. Coughing is preferable and more effective than suction.
How to Cough After Surgery
When you feel the urge to cough, brace your incision if you have had a chest or abdominal surgery. Take your hands or a small pillow and hug it to the wound with gentle but firm pressure. Bracing helps support your incision and reduces stress on the site.
If you don't have a pillow, you can use your hands to brace the incision. The pillow is mainly for comfort.
Even if your incision is not on your chest or abdomen, bracing may help with pain control. Crossing your legs can also brace the incision if your surgery was in the genital or rectal areas.
Dehiscence, also called wound separation, is a surgical complication where the edges of a repaired wound begin to pull apart, either on their own or due to force. It can become very serious.
This is why the wound must be handled very carefully during the first two weeks after surgery when an incision can most easily come apart.
Bracing your incision is important for several reasons. Holding pressure on your incision decreases the stress on it, which can decrease the pain.
During your routine incision care, look for signs that the incision is pulling apart or gaps are forming. Small openings may not be an issue, but they can widen if the wound is stressed.
For example, a person with a cold may cough frequently, putting extra stress on an abdominal incision. This increases the risk of opening. The same applies to sneezing. Bracing will help protect your incision and minimize the pain.
Never stifle a sneeze. Doing so may tear blood vessels in the throat, damage the eardrum and inner ear, or even trigger an aneurysm. Simply brace the incision, tense the surrounding muscles, and sneeze.
Coughing and Breathing Exercises
Coughing and deep breathing (CDB) is a technique used to help keep the lungs clear during the first few days or weeks after surgery. The exercises are an effective tool to prevent pneumonia and atelectasis, a lung condition where the lungs don't expand the way they should.
The technique varies slightly from place to place, but the general idea is the same. To perform a CDB exercise:
Take a deep breath, hold for several seconds, and slowly exhale.
Repeat five times.
Brace your incision, and attempt to cough deeply.
Repeat the entire procedure every one to two hours.
Other options for clearing your lungs after surgery include positive expiratory pressure (PEP) therapy or an acapella device.
While in the hospital a respiratory therapist may prescribe PEP therapy. PEP uses a device with a mask or mouthpiece that you breathe through 10 to 15 times per cycle. When breathing out, the device creates positive pressure in your lungs to help open small airways and air sacs deep in the lungs that might otherwise stay closed because of mucus blockage.
After completing these exercises, be sure to cough to remove mucus in your lungs.
Another device that may be prescribed is the acapella device. This device uses a counter-weighted plug and magnet to create vibrations and resistance that help move mucus out of your airways. Just like with PEP therapy, you should breathe in and out through the device 10 to 15 times, resting as needed.
These devices are prescribed based on your condition and ability to take deep and effective breaths on your own.
When to Call a Healthcare Provider
Call a healthcare provider if:
You notice an opening in your incision, even a small one.
You notice blood after coughing.
Coughing causes severe pain.
You cannot brace (or hold) an incision because it is too painful.
You feel too weak to cough or are not strong enough to cough effectively.
You have difficulty breathing or cannot catch your breath.
Coughing after surgery is an important part of your post-surgical care. It clears the lungs of any mucus that has built up and helps prevent pneumonia and other lung complications.
Still, coughing when you have a surgical wound can be painful. To make it easier, place your hands or a pillow over the incision to brace it. Then tighten the muscles around the wound and cough. Bracing not only lessens the pain of coughing, but it can also keep your wound from opening up.
In addition to coughing, it's a good idea to practice deep breathing exercises every couple of hours in the days after surgery. Like coughing, these exercises will help keep your lungs clear.
Frequently Asked Questions
Is coughing up phlegm after surgery normal?
Coughing up phlegm or mucus after surgery is normal. It's a natural, vital way the body gets rid of excess lung mucus. If mucus is stuck in the lungs for too long, an infection can start. That's why it's important to regularly cough after surgery, even if it can be unpleasant.
Why am I wheezing after surgery?
If you are wheezing after surgery, you may have a lung (pulmonary) complication. A pulmonary complication can appear if you don't do deep breathing and coughing exercises in the first 48 hours after surgery. Other symptoms can include chest pain, fever, and a cough. If you experience these symptoms after surgery, contact your doctor.
Is sneezing dangerous after surgery?
Only if it's done incorrectly. Try not to stifle a sneeze—holding it back can cause further issues, such as an incision opening. If you feel a sneeze on its way, brace the incision, tighten your abdominal muscles, and then sneeze.
Read the original article on Verywell Health.