PPG - Tecnologias e Atenção à Saúde

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Navegando PPG - Tecnologias e Atenção à Saúde por Autor "Bachichi, Thiago Gangi [UNIFESP]"

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    Drenagem torácica no mesmo espaço intercostal da toracotomia, estudo prospectivo randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2016-08-31) Bachichi, Thiago Gangi [UNIFESP]; Costa Junior, Altair da Silva Costa Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The open thoracic surgery, thoracotomy, is the most common surgical approach used for treatment of chest diseases. It is necessary look for new techniques and resources, like other ways of thoracic drainage, to reduce the pain and to minimize the surgical aggression. Objective: To compare the chest tube through the same thoracotomy intercostal space with traditional one, on patients undergoing on muscle-sparing thoracotomy. Method: We evaluated 40 patients older than 18 years undergone to elective muscle sparing thoracotomies. They were divided into two groups of 20 patients, one of them undergoing thoracic drainage by the same intercostal space of thoracotomy (ID) and the other subjected to traditional drainage (TD). The results were compared and statistically analyzed. Results: We obtained in DI group, median length of stay in the ICU of 1.5 days (1.0 - 2.0) and 2.0 days (1.25 - 3.0) in the DT group (p=0.060). The medians of length of stay (p=0.527) and drain (p=0.547) were both 4 days in the group ID, and 2 and 5.5 days, respectively, in the TD group. The anesthetic doses administered through the epidural catheter were similar, 59.8 mL ± 43.33 in the ID group and 54.0 ± 23:37 in the TD group (p=0.60). Dipirona and tramadol doses also did not differ between groups (p=0.201 and p=0.341). The mean pain values scale on first postoperative (POD) were 4.24 in the ID group and 3.95 in the TD (p=0.733); on POD-3 was 3.18 for the DI group and 3.11 in the DT (p=0.937). At POD-15 the pain score on drainage through the incision was 1.53 and on traditional drainage 2.11 (p=0.440), on POD-30 was 0.71 and 0.84 respectively (p=0.787). Regarding the complications both groups were similar, with 30% in ID and 25% in TD (p=0.723). The most common complications were atrial fibrillation, with two patients in DI, and prolonged air loss with two patients in DT. Conclusion: In conclusion, there was no statistic difference between groups in postoperative data. The drainage through the same thoracotomy intercostal space was feasible and effective on the studied period (thirty days).