J Korean Med Sci.  2014 Oct;29(10):1398-1403. 10.3346/jkms.2014.29.10.1398.

Application of Lidocaine Jelly on Chest Tubes to Reduce Pain Caused by Drainage Catheter after Coronary Artery Bypass Surgery

Affiliations
  • 1Heart Research Institute, Chung-Ang University College of Medicine, Seoul, Korea. Joonhwa.hong@gmail.com
  • 2Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Department of Thoracic and Cardiovascular Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
  • 4Department of Cardiology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 5Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Abstract

The objective of this study was to assess the effect of lidocaine jelly application to chest tubes on the intensity and duration of overall pain, chest tube site pain and the required analgesics for postoperative pain relief in coronary artery bypass graft (CABG) patients. For patients in group L, we applied sterile 2% lidocaine jelly on the chest tubes just before insertion, and for patients in group C, we applied normal saline. Overall visual analogue scale (VAS), maximal pain area with their VAS were documented postoperatively, and the frequency that button of patient-controlled analgesia was pressed (FPB) and total fentanyl consumption were assessed. The number of patients who complained that tube site was the most painful site was significantly higher in group C than in group L (85% vs. 30% at extubation, P<0.001). The overall VAS score was significantly higher in group C than in group L (39.14+/-12.49 vs. 27.74+/-13.76 at extubation, P=0.006). After all of the tubes were removed, the VAS score decreased more in group C (5.74+/-4.77, P<0.001) than in group L (3.05+/-2.48, P<0.001). FPB and total fentanyl consumption were significantly higher in group C than in group L (73.00, 59.00-78.00 vs. 34.00, 31.00-39.25, P<0.001; 2,214.65+/-37.01 vs. 1,720.19+/-361.63, P<0.001, respectively). Lidocaine jelly application is a very simple way to reduce postoperative pain by reducing chest tube site pain after CABG. (Clinical Trials Registry No. ACTRN 12611001215910)

Keyword

Coronary Artery Bypass; Pain, Postoperative; Analgesia

MeSH Terms

Adolescent
Adult
Aged
Analgesia, Patient-Controlled
Anesthetics, Local/*therapeutic use
Cardiac Catheters/adverse effects
Chest Tubes/*adverse effects
Coronary Artery Bypass
Drainage
Female
Fentanyl/therapeutic use
Humans
Lidocaine/*therapeutic use
Male
Middle Aged
Pain Management/*methods
Pain Measurement
Pain, Postoperative/*drug therapy
Random Allocation
Young Adult
Anesthetics, Local
Fentanyl
Lidocaine

Figure

  • Fig. 1 A CONSORT Diagram. IABP, intra-aortic balloon pump.

  • Fig. 2 Overall pain score. VAS, visual analogue scale; POD, postoperative day. Values are expressed as mean±SE. *P<0.05 compared with group C.

  • Fig. 3 Pain score at the most painful site. VAS, visual analogue scale; POD, postoperative day. Values are expressed as mean±SE. *P<0.05 compared with group C.

  • Fig. 4 Overall pain score before and after the tubes removal. VAS, visual analogue scale. Values are expressed as mean±SE. *P<0.05 compared with group C; †P<0.05 compared with before tube removal.


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