Managing pain during mediastinal chest tube removal.

Autor:	Carson MM; University of Virginia Health Sciences Center, Charlottesville., Barton DM, Morrison CC, Tribble CG
Jazyk:	angličtina
Zdroj:	Heart & lung : the journal of critical care [Heart Lung] 1994 Nov-Dec; Vol. 23 (6), pp. 500-5.
Abstrakt:	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.
Databáze:	MEDLINE
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