Thorac cardiovasc Surg
DOI: 10.1055/s-0035-1558994
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Local Anesthetics delivered through Pleural Drainages improve Pain and Lung Function after Cardiac Surgery

Bakr Mashaqi1, *, Issam Ismail1, *, Thierry T. Siemeni1, Stefan Ruemke1, Felix Fleissner1, Ruoyu Zhang1, Bettina Wiegmann1, Joerg Filitz2, Jens Gottlieb3, Axel Haverich1
  • 1Department of Thoracic, Transplant and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
  • 2Department of Anesthesiology and Intensive Care, Hannover Medical School, Hanover, Germany
  • 3Department of Respiratory Medicine, Hannover Medical School, Hanover, Germany
  • *Both the authors contributed equally to this work.
Further Information

Publication History

23 April 2015

09 June 2015

Publication Date:
03 September 2015 (eFirst)

Abstract

Objective 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.

Methods 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.

Results 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).

Conclusion Intrapleural application of lidocaine is a safe and feasible method to reduce drainage-related pain and improving lung function after CABG.