Subxiphoid versus intercostal chest tubes: comparison of postoperative pain and pulmonary morbidities after coronary artery bypass grafting.

Publisher: published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute Country of Publication: United States NLM ID: 8214622 Publication Model: Print Cited Medium: Internet ISSN: 1526-6702 (Electronic) Linking ISSN: 07302347 NLM ISO Abbreviation: Tex Heart Inst J Subsets: MEDLINE

Original Publication: Houston, TX : published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute, c1982-

Chest Tubes*; Coronary Artery Bypass/*adverse effects ; Drainage/*adverse effects ; Drainage/*instrumentation ; Lung Diseases/*etiology ; Pain, Postoperative/*etiology; Aged ; Analgesics/therapeutic use ; Chi-Square Distribution ; Elective Surgical Procedures ; Equipment Design ; Female ; Humans ; Length of Stay ; Lung Diseases/diagnosis ; Male ; Middle Aged ; Pain, Postoperative/diagnosis ; Pain, Postoperative/drug therapy ; Pleural Effusion/etiology ; Prospective Studies ; Pulmonary Atelectasis/etiology ; Time Factors ; Treatment Outcome ; Turkey

Chest tubes are one cause of pain after cardiac surgery. In a prospective, randomized study, we investigated the effects of the position of chest tubes on acute postoperative pain and pulmonary morbidities in patients who underwent coronary artery bypass grafting. From June through December 2010, 40 patients who underwent elective coronary artery bypass grafting were enrolled in the study. We investigated 2 randomized groups of patients: Group 1 (n-20) had a left chest tube inserted through the midline inferior to the xiphoid process (subxiphoid approach), and Group 2 (n-20) had a left chest tube inserted through the 6th intercostal space along the anterior axillary line (intercostal approach). We compared the results with respect to postoperative pain, the need for analgesic agents, chest-tube drainage, pulmonary morbidities, and duration of hospitalization. The intensity of postoperative pain was similar between the groups. The cumulative doses of analgesic agents, incidence of pulmonary morbidities, and duration of hospitalization were also similar. Pleural effusion and atelectasis were each diagnosed in 3 patients in Group 1 (15%) and 1 patient in Group 2 (5%) (both P=0.68). Two of the patients in Group 1 required drainage of the pleural effusion. In our study, we found that the subxiphoid and intercostal approaches for chest-tube placement yielded similar clinical outcomes.

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Keywords: Analgesics, non-narcotic/therapeutic use; chest pain/etiology; chest tubes; coronary artery bypass/methods; pain, postoperative/etiology/prevention & control; pleural effusion/etiology; postoperative complications/etiology; respiratory mechanics; suction/instrumentation

0 (Analgesics)

Date Created: 20120906 Date Completed: 20130121 Latest Revision: 20220311

20231215

PMC3423278

22949766