Comparison of two pain-management strategies during chest tube removal: Relaxation exercise with opioids and opioids alone

AbstractLimited evidence exists to guide chest tube management following cardiac surgery in children. We assessed chest tube practice variation by surveying paediatric heart centres to prepare for a multi-site quality improvement project. We summarised management strategies highlighting variability in criteria for chest tube removal between and within centres. This lack of standardisation provides an opportunity for quality improvement.

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Cold therapy and respiratory relaxation exercise on pain and anxiety related to chest tube removal: A clinical trial

Iranian Journal of Nursing and Midwifery Research ◽

10.4103/ijnmr.ijnmr_228_19 ◽

2021 ◽

Vol 26 (1) ◽

pp. 54

Author(s):

Zahra Rooddehghan ◽

Zahra Sajedi-Monfared ◽

Hamid Haghani ◽

AliReza Bakhshandeh ◽

LayaSajedi Monfared

Keyword(s):

Clinical Trial ◽

Chest Tube ◽

Cold Therapy ◽

Tube Removal ◽

Chest Tube Removal ◽

Relaxation Exercise

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COMPARISON OF TWO ANALGESIA TECHNIQUES FOR PAIN MANAGEMENT DURING CHEST TUBE REMOVAL AFTER CARDIAC SURGERY

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/2035 ◽

2015 ◽

Vol 4 (82) ◽

pp. 14306-14312

Author(s):

Gaurav Goyal ◽

Varun Chhabra ◽

Premraj Nagarwal ◽

Ashish Jain

Keyword(s):

Cardiac Surgery ◽

Pain Management ◽

Chest Tube ◽

Tube Removal ◽

Chest Tube Removal

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Chest tube removal practices in critical care units in the United States

American Journal of Critical Care ◽

10.4037/ajcc1995.4.6.419 ◽

1995 ◽

Vol 4 (6) ◽

pp. 419-424 ◽

Cited By ~ 32

Author(s):

MR Kinney ◽

KT Kirchhoff ◽

KA Puntillo

Keyword(s):

United States ◽

Critical Care ◽

Pain Management ◽

Chest Tube ◽

Management Practices ◽

The United States ◽

Chest Tubes ◽

Critical Care Units ◽

Tube Removal ◽

Chest Tube Removal

BACKGROUND: Pain assessment and management are recognized as major problems in critical care settings. However, little is known about pain management practices related to medical procedures performed in the ICU, particularly removal of chest tubes. OBJECTIVES: To describe practices related to chest tube removal in the United States, with an emphasis on pain assessment and management. METHODS: A survey instrument was developed and mailed to 995 members of the American Association of Critical-Care Nurses who cared for patients with chest tubes. They were asked about chest tube removal practices in their institutions. RESULTS: Chest tubes are removed primarily by physicians and house staff, although 11% of respondents reported that specially trained nurses removed the tubes. Only 16% indicated that a prescription for pain medication was routinely available before chest tube removal. The drug administered most frequently was intravenous morphine sulfate, but the dose varied considerably. Nurses were generally satisfied (65.6%) with practices related to chest tube removal in their unit; nurses who were not satisfied (34.4%) wished to see better pain management practices (45%), removal of tubes by the patient's assigned nurse (17.8%), a protocol for tube removal (13.9%), notification of the nurse before removal (12.2%), and other changes (10%). CONCLUSIONS: Practices associated with chest tube removal, especially pharmacologic management of procedure-related pain, vary in critical care units. Caregivers are advised to develop practice policies to guide decisions about management of acute pain in this patient population.

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Autologous Blood Pleurodesis: What Is the Optimal Time Interval and Amount of Blood?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0041-1727129 ◽

2021 ◽

Author(s):

Alessio Campisi ◽

Andrea Dell'Amore ◽

Yonghui Zhang ◽

Zhitao Gu ◽

Angelo Paolo Ciarrocchi ◽

...

Keyword(s):

Chest Tube ◽

Autologous Blood ◽

Optimal Time ◽

Time Interval ◽

Air Leak ◽

Increased Risk ◽

Tube Removal ◽

Blood Patch ◽

Prolonged Air Leak ◽

Chest Tube Removal

Abstract Background Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized. Methods We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed. Results After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1–13) after ABPP were also statistically different (p < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis. Conclusion In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped.

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