Author/Authors :
Sokouti، Mohsen نويسنده , , Abri Aghdam، Babak نويسنده Department of Thoracic Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, TABRIZ – IRAN. , , Golzari، Samad Eslam Jamal نويسنده Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences , , Moghadaszadeh، Majid نويسنده Branch, Islamic Azad University, Tabriz, Iran. ,
Abstract :
Background: Postoperative pulmonary complications and pain are important causes of postoperative morbidity following
thoracotomy. This study aimed to compare the effects of fast track and conservative treatment regimens on patients
undergoing thoracotomy.
Materials and Methods: In this randomized controlled clinical trial, we recruited 60 patients admitted to the thoracic ICU of
Imam Reza Hospital in two matched groups of 30 patients each. Group 1 patients received fast track regimen randomly;
whereas, group 2 cases randomly received conservative analgesic regimen after thoracotomy and pulmonary resection. The
outcome was determined based on the incidence of pulmonary complications and reduction of post-thoracotomy pain in all
patients with forced expiratory volume in one second (FEV1) < 75% predicted value which was measured while the patients
were in ICU. The length of ICU stay, thoracotomy pain, morbidity, pulmonary complications and mortality were compared in
two groups.
Results: A total of 60 patients, 45 (75%) males and 15(25%) females with ASA class I-III were recruited in this study.
Postoperative pulmonary complications were observed in 5 (16.7%) patients in group 1 versus 17 (56.7%) patients in group
2. There were statistically significant differences in development of postoperative pulmonary complications such as
atelectasis and prolonged air leak between both groups (P < 0.001 and P=0.003). There was also a statistically significant
difference in the rate of preoperative FEV1 (p=0.001) and ASA scoring (p=0.01) and value of FEV1 < 75% predicted in the two
groups. The difference in length of ICU stay in two groups was statistically significant (P= 0.003 and P=0.017 in FEV1 < 75%
group). Four patients in group 1 and 9 patients in group 2 had FEV1reduced to less than 75% of predicted value (p=0.03).
Conclusion: Using fast track regimen reduced postoperative pain and incidence of some pulmonary complications
significantly when compared to the conservative regimen following thoracotomy and various lung surgeries.
