AI Article Synopsis
- The study examined the impact of pleural integrity on respiratory function and pain after coronary bypass surgery in patients undergoing median sternotomy.
- Patients were divided into two groups: Group I had intact pleural cavities during surgery, while Group II had open pleural cavities.
- Results showed that Group II had significantly poorer pulmonary function, higher pain scores, and increased rates of complications like pleural effusions and atelectasis compared to Group I following surgery.
- Preserving pleural integrity is essential for better postoperative outcomes in terms of respiratory health and pain management.
Article Abstract
Background And Aim: Patients undergoing surgical procedures through median sternotomy have reduced pulmonary function in the postoperative period. Our study was designed to evaluate the effect of pleural integrity in terms of respiratory functions and pain score after coronary bypass procedures.
Methods: In a randomized, prospective study we evaluated 320 patients in two groups. Group I (n = 160) patients were the patients whose pleural cavity was intact while internal mammary artery (IMA) harvesting, and in group II (n = 160) the pleural cavity of the patients was opened. They matched in terms of postoperative respiratory functions and pain score.
Results: FEV1 (%) and FEV1/FVC levels at the postoperative fifth day were significantly lower in group II (I = 71.5 +/- 4.9 vs. II = 63.5 +/- 8.3 and I = 24.1 vs. II = 22.1), respectively (p < 0.05). The rate of postoperative pleural effusions and atelectasis at the postoperative fifth day were significantly higher in group II (I = 35%, 15% vs. II = 48%, 35%), respectively (p < 0.05). The pain score was higher in group II at postoperative fifth day.
Conclusions: All patients undergoing cardiac surgery suffer deterioration in pulmonary functions. Pleurotomy seems to compound this with increased rates of atelectasis and pleural effusions. Moreover, preserving pleural integrity provides beneficial effects on pain score after coronary operations especially in the early postoperative period.
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| http://dx.doi.org/10.1111/j.1540-8191.2008.00734.x | DOI Listing |
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