Local Anesthetics delivered through Pleural Drainages improve Pain and Lung Function after Cardiac Surgery.
Pleural tubes after coronary artery bypass graft (CABG) surgery usually cause pain resulting interalia in an impact of postoperative breathing. Therefore, the influence of intrapleural lidocaine application through special double-lumen chest tubes with respect to pain relief and lung function was investigated and compared with placebo.



In this study, 40 patients who underwent CABG got intrapleural injection either with 2% lidocaine (n= 20) or placebo (0.9% saline solution) (n= 20) on the first 2 days after surgery. Pain was measured by pain intensity numeric rating scale (NRS) (0 = no pain; 10 = the most intense pain) and lung function by portable spirometer.



On the first postoperative day (POD1), mean pain reduction was NRS 1.9 for the lidocaine group with an improvement of the forced expiratory volume in 1 second (FEV1) of 0.51 L. Similar results were shown on the second postoperative day (POD2) with a decreased pain level of mean NRS 1.65 and an FEV1 improvement of 0.26 L. In comparison, results of the placebo group showed no significant pain reduction, neither on the POD1 (NRS 0.35;p= 0.429) nor on the POD2 (NRS 0.55;p= 0.159). Also, there was no significant influence of FEV1 after placebo on the POD1 (FEV1 = 0.048 L;p= 0.70) or on the POD2 (FEV1 = 0.0135 L;p= 0.925).



Intrapleural application of lidocaine is a safe and feasible method to reduce drainage-related pain and improving lung function after CABG.
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.|Both the authors contributed equally to this work.
Bakr
B
Mashaqi
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.|Both the authors contributed equally to this work.
Issam
I
Ismail
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Thierry T
TT
Siemeni
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Stefan
S
Ruemke
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Felix
F
Fleissner
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Ruoyu
R
Zhang
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Bettina
B
Wiegmann
Department of Anesthesiology and Intensive Care, Hannover Medical School, Hanover, Germany.
Joerg
J
Filitz
Department of Respiratory Medicine, Hannover Medical School, Hanover, Germany.
Jens
J
Gottlieb
Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Axel
A
Haverich
D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D015505:Chest Tubes; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004311:Double-Blind Method; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D005541:Forced Expiratory Volume; D005858:Germany; D006801:Humans; D055770:Interpleural Analgesia / Q000009:adverse effects / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D020127:Recovery of Function; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine