Topical analgesia for chest tube removal in cardiac patients.
OBJECTIVE
The aim of this study was to evaluate the efficacy of topical valdecoxib as an analgesic during chest tube removal in postcardiac surgical patients.


METHODS
A prospective, randomized, double-blind, placebo-controlled study.


METHODS
The study was performed in the cardiac intensive care unit.


METHODS
Fifty-three patients undergoing elective cardiac surgery were randomized to receive either topical valdecoxib or liquid paraffin on the chest tube exit sites.


METHODS
Topical valdecoxib was applied to 1 of the 2 chest tube sites (mediastinal or pericardial) in a randomized manner before drain removal. Liquid paraffin was used as the control on the other tube site. The patient and observer were blinded to the drug and control.


RESULTS
Pain was assessed by using the visual analog scale. The heart rate and systolic blood pressure were recorded at each stage by the blinded observer. Statistical analysis of the obtained data was undertaken using the nonparametric Mann-Whitney U test. The median pain scores before, during, and after tube removal in the control group were 2, 5, and 4, respectively. The valdecoxib group had corresponding scores of 1, 2, and 2. The pain scores were significantly lower in the valdecoxib group. No differences were seen in the heart rate and systolic blood pressure between the 2 groups. No adverse effects were noted.


CONCLUSIONS
Topical valdecoxib is a safe and effective topical analgesic for chest tube removal in cardiac patients.
Singh
Madhavi
M
Department of Anesthesia, Nizams Institute of Medical Sciences, Andhra Pradesh, India. madhavidev@hotmail.com
Gopinath
Ramachandran
R
D000287:Administration, Topical; D000698:Analgesia; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D016718:Arachidonic Acid / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D006348:Cardiac Surgical Procedures; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010147:Pain Measurement / Q000187:drug effects; D010232:Paraffin; D010592:Pharmaceutic Aids; D010743:Phospholipids / Q000378:metabolism; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000096926:Benzenesulfonamides
D000700:Analgesics; D016718:Arachidonic Acid; D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; D010232:Paraffin; D010592:Pharmaceutic Aids; D010743:Phospholipids; D013449:Sulfonamides; C406224:valdecoxib; D000096926:Benzenesulfonamides