Randomized controlled trial of an alternative drainage strategy vs routine chest tube insertion for postoperative pain after thoracoscopic wedge resection

• Published in: BMC anesthesiology Vol. 22; no. 1; p. 27
• Main Authors: Wei, Shoucun, Zhang, Guangyan, Ma, Jue, Nong, Lidan, Zhang, Jiatao, Zhong, Wenzhao, Cui, Jianxiu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.01.2022; BioMed Central; BMC
• Subjects: Analgesics; Anesthesia; Care and treatment; Catheters; Chest; Chest tube; Chest Tubes; Chronic pain; Clinical trials; Double-lumen central venous catheter; Drainage - methods; Extubation; Female; Hospitalization; Hospitals; Humans; Inflammation; Length of Stay - statistics & numerical data; Lung - surgery; Lung Neoplasms - surgery; Male; Middle Aged; Nonsteroidal anti-inflammatory drugs; Ostomy; Pain; Pain management; Pain, Postoperative; Pain, Postoperative - prevention & control; Patients; Pneumonectomy - methods; Postoperative pain; Postoperative period; Prospective Studies; Recovery (Medical); Software; Surgery; Surgical drains; Thoracic surgery; Thoracic Surgery, Video-Assisted - methods; Thoracoscopic wedge resection; Thoracotomy - methods; Thorax; Venture capital; Venture capital companies; Wound drainage; United States > US; Double-lumen central venous catheter; Postoperative pain; Thoracoscopic wedge resection; Chest tube
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-022-01569-w

Thoracoscopic surgery has greatly alleviated the postoperative pain of patients, but postsurgical acute and chronic pain still exists and needs to be addressed. Indwelling drainage tubes are one of the leading causes of postoperative pain after thoracic surgery. Therefore, the aim of this study was to explore the effects of alternative drainage on acute and chronic pain after video-assisted thoracoscopic surgery (VATS). Ninety-two patients undergoing lung wedge resection were selected and randomly assigned to the conventional chest tube (CT) group and the 7-Fr central venous catheter (VC) group. Next, the numeric rating scale (NRS) and pain DETECT questionnaire were applied to evaluate the level and characteristics of postoperative pain. NRS scores of the VC group during hospitalization were significantly lower than those of the CT group 6 h after surgery, at postoperative day 1, at postoperative day 2, and at the moment of drainage tube removal. Moreover, the number of postoperative salvage analgesics (such as nonsteroidal anti-inflammatory drugs [(NSAIDs]) and postoperative hospitalization days were notably reduced in the VC group compared with the CT group. However, no significant difference was observed in terms of NRS pain scores between the two groups of patients during the follow-up for chronic pain at 3 months and 6 months. In conclusion, a drainage strategy using a 7-Fr central VC can effectively relieve perioperative pain in selected patients undergoing VATS wedge resection, and this may promote the rapid recovery of such patients after surgery. ClinicalTrials.gov, NCT03230019. Registered July 23, 2017.