Impact of duration of chest tube drainage on pain after cardiac surgery.
OBJECTIVE
This study was designed to analyze the duration of chest tube drainage on pain intensity and distribution after cardiac surgery.


METHODS
Two groups of 80 cardiac surgery adult patients, operated on in two different hospitals, by the same group of cardiac surgeons, and with similar postoperative strategies, were compared. However, in one hospital (long drainage group), a conservative policy was adopted with the removal the chest tubes by postoperative day (POD) 2 or 3, while in the second hospital (short drainage group), all the drains were usually removed on POD 1.


RESULTS
There was a trend toward less pain in the short drainage group, with a statistically significant difference on POD 2 (P=0.047). There were less patients without pain on POD 3 in the long drainage group (P=0. 01). The areas corresponding to the tract of the pleural tube, namely the epigastric area, the left basis of the thorax, and the left shoulder were more often involved in the long drainage group. There were three pneumonias in each group and no patient required repeated drainage.


CONCLUSIONS
A policy of early chest drain ablation limits pain sensation and simplifies nursing care, without increasing the need for repeated pleural puncture. Therefore, a policy of short drainage after cardiac surgery should be recommended.
Mueller
X M
XM
Clinic for Cardiovascular Surgery and Surgical Intensive Care Unit, CHUV (Centre Hospitalier Universitaire Vaudois), CH-1011, Lausanne, Switzerland. xavier.mueller@chuv.hospvd.ch
Tinguely
F
F
Tevaearai
H T
HT
Ravussin
P
P
Stumpe
F
F
von Segesser
L K
LK
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015505:Chest Tubes / Q000009:adverse effects*; D004322:Drainage / Q000009:adverse effects*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D011446:Prospective Studies; D012086:Reoperation; D013997:Time Factors