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INVESTIGATION OF EFFECTS OF DIFFERENT DRAINAGE METHODS ON POSTOPERATIVE PLEURAL COMPLICATIONS AND PAIN IN OFF-PUMP SURGERY
  • FERHAT BORULU,
  • Yusuf Velioglu
FERHAT BORULU
Atatürk University
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Yusuf Velioglu
Abant Izzat Baysal University Faculty of Medicine
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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.