INVESTIGATION OF EFFECTS OF DIFFERENT DRAINAGE METHODS ON POSTOPERATIVE
PLEURAL COMPLICATIONS AND PAIN IN OFF-PUMP SURGERY
Abstract
ABSTRACT Background The aim of this study was to investigate whether the
need for thoracic tubes placed in the intercostal space, which cause
severe pain in postoperative period and serious problems in pulmonary
rehabilitation, could be eliminated by Jackson drains placed in
mediastinum in patients who undergo off-pump surgery. Method A
prospective analysis of 135 patients who underwent routine off-pump
isolated CABG surgery in our clinic between January 2017 and June 2018
was performed. 65 patients had subxiphoid mediastinal drains and
intercostal chest drains, and 64 patients had one subxiphoid mediastinal
drain and one mediastinal Jackson drain. Postoperative pain scores,
analgesic needs of patients, radiologically, effusion and pneumothorax
assessments were recorded and pleural complications requiring invasive
intervention were compared. Results There was no difference between the
groups in terms of age, gender and comorbidities. In terms of pain
scoring and analgesia requirement at the first hour after intubation,
there was a significant superiority in all follow-up periods in group 2
(p˂0.001). In 2 patients in group 1 (3.1%) and in two patients in group
2 (3.07%) pleural effusion requiring intervention was detected. There
was no significant difference between the two groups in terms of
effusion pneumothorax, in terms of blood transfusion and other
postoperative complications, postoperative whole blood replacement was
higher in group 2 (P = 0.002). Conclusion Based on the results of the
present study, we concluded that it was not necessary to insert
intercostal chest tubes especially in off-pump surgery.