Background: There is a significant chance of both postoperative mortality and complication
rate with major abdominal surgery. Various interventions are available that aim to lower the
possibility of pulmonary problems following surgery, reduce postoperative pain. One of these
interventions is the breathing method known as the active cycle (ACBT). Objective: To determine the
impact of implementing an active cycle breathing technique on postoperative pain of and on
respiratory health outcomes of patients undergoing major abdominal surgeries. Settings: The study
was carried out at the Gastrointestinal, Hepatobiliary, and Pancreatic Surgery Units, at Alexandria
Main University Hospital. Subjects: A convenience sample of 80 adult patients, who were divided into
two equal groups (study and control group) were recruited for the study. Tools: four tools were used.
Tool I: Patients' socio-demographic and clinical data structured interview schedule, Tool II: Pain
visual analogue rating scale, Tool III: Postoperative respiratory health outcomes assessment sheet,
and Tool IV: Active cycle breathing technique educational session' intervention effectiveness
evaluation tool. Results: The ACBT sessions had a potent effect on pain severity with an effect size of
(0.989). In addition, there is a large effect of the ACBT on the study group patient's respiratory
outcomes (0.975). Conclusion: Active cycle breathing technique application for the study group
patients proved to have appositive effect in relation to patient's respiratory outcomes and there were
statistically meaningful variations were found between the study group before and after ACBT overall
sessions except in the 8th session regarding pain. Recommendations: Establishing regular ongoing
educational programs and workshops for updating of nurses knowledge regarding the active cycle
breathing technique as air way clearance technique. Furthermore, for pain assessment and
management and the developed illustrated booklet should be available and distributed in both Arabic
and English language in all surgical units.