Alternative Thoracic Drainage Strategy Alleviates Perioperative Pain After Lung Wedge Resection: A Randomized Controlled Trial

Abstract

\n Background: Indwelling thoracic drainage tube is one of the leading causes of postoperative pain after thoracotomy. Currently, limited evidence exists on evaluating the acute and chronic pain resulting from chest tube after video-assisted thoracic surgery (VATS). Herein, we intended to explore an alternative drainage method and its impact on acute and chronic pain after VATS. Methods: For this purpose, ninety-two patients undergoing lung wedge resection were selected and randomly assigned to conventional chest tube (CT) group and venous catheter (VC) group, respectively. Then, the numeric rating scale (NRS) and pain DETECT questionnaire were applied to evaluate the level and characteristics of postoperative pain. Results: Our data showed that the NRS scores of the VC group during hospitalization were significantly lower than those of the CT group 6 hours after surgery, at postoperative day 1, at postoperative day 2, and at the moment of drainage tube removal), respectively. Moreover, the number of postoperative salvage analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) used in the VC group and postoperative hospitalization days were notably reduced compared with the CT group. However, no significant difference was observed in terms of NRS pain scores between the two groups of patients during the follow-up for chronic pain at 3 months and 6 months. Conclusion: Taken together, the drainage strategy mentioned in this article is effective in relieving perioperative acute pain and reducing the use of salvage analgesics in selected patients undergoing VATS wedge resection, which is beneficial for the rapid recovery of patients after surgery.Trial registration: ClinicalTrials.gov, NCT03230019. Registered July 23, 2017