OBJECTIVE: To compare four analgesic regimens used in preparing patients for chest tube removal. DESIGN: Prospective, randomized, controlled multiple-group comparison. SETTING: Mid-atlantic university affiliated tertiary medical center. PATIENTS: 80 adult patients who underwent heart surgery and who had two mediastinal chest tubes. OUTCOME MEASURES: Subject's pain intensity rating on a 0 to 100 mm visual analog scale and subject's description of sensations blindly rated by six nurses. INTERVENTION: Before chest tube removal, subjects were medicated with either: (1) intravenous morphine sulfate (morphine), (2) intravenous morphine and subfascial angiocatheter lidocaine hydrochloride (lidocaine), (3) intravenous morphine and subfascial angiocatheter normal saline solution, or (4) subfascial angiocatheter lidocaine. RESULTS:Mean pain rating scores for groups 1, 2, 3, and 4 were 43.7 40.9, 36.4, and 38.1, respectively. Analysis of variance showed no significant difference between scores (p = 0.8948). The percentage of comments rated as "not bad at all" or "not bad" for groups 1, 2, 3, and 4 were 56%, 83%, 47% and 75%, respectively. Chi-square analysis showed a significant difference between ratings (p < 0.01). CONCLUSIONS: Blind ratings of subjects' descriptions of sensations suggest subfascial lidocaine may be useful in reducing discomfort during chest tube removal.
RCT Entities:
OBJECTIVE: To compare four analgesic regimens used in preparing patients for chest tube removal. DESIGN: Prospective, randomized, controlled multiple-group comparison. SETTING: Mid-atlantic university affiliated tertiary medical center. PATIENTS: 80 adult patients who underwent heart surgery and who had two mediastinal chest tubes. OUTCOME MEASURES: Subject's pain intensity rating on a 0 to 100 mm visual analog scale and subject's description of sensations blindly rated by six nurses. INTERVENTION: Before chest tube removal, subjects were medicated with either: (1) intravenous morphine sulfate (morphine), (2) intravenous morphine and subfascial angiocatheter lidocaine hydrochloride (lidocaine), (3) intravenous morphine and subfascial angiocatheter normal saline solution, or (4) subfascial angiocatheter lidocaine. RESULTS: Mean pain rating scores for groups 1, 2, 3, and 4 were 43.7 40.9, 36.4, and 38.1, respectively. Analysis of variance showed no significant difference between scores (p = 0.8948). The percentage of comments rated as "not bad at all" or "not bad" for groups 1, 2, 3, and 4 were 56%, 83%, 47% and 75%, respectively. Chi-square analysis showed a significant difference between ratings (p < 0.01). CONCLUSIONS: Blind ratings of subjects' descriptions of sensations suggest subfascial lidocaine may be useful in reducing discomfort during chest tube removal.
Authors: Driss Laghlam; Cecile Naudin; Lucas Coroyer; Vincent Aidan; Julien Malvy; Ghilas Rahoual; Philippe Estagnasié; Pierre Squara Journal: Ann Intensive Care Date: 2021-05-13 Impact factor: 6.925