Pain Med for Chest Tube Removal

[CRNAsoon]

I recently read a journal article regarding the importance or pre-medicating pt's with pain meds before chest tube removal, but in my limited experience I've only seen this done a few times. I'm just wondering how often this does happen and what type of meds are typically used. Do you give medication prior to pulling chest tubes?

[CRNAsoon]

CRNAStudent,

Sounds like you have a good head on your shoulders (but then again, you are in CRNA school). I agree that patients should always know what to expect before we touch them and that they should have the right to pain meds if they so desire. Good luck in school and hope to see you in the OR.

:-) CRNAsoon

[Bella 31]

For what it's worth in the UK,where I used to work, myself and a group of colleagues worked with the acute pain team to set up an entonox service for chest drain removeal. As an inhaled analgesic that the patient controls, it's safe, easy to use, effective and economical. We did some research on patient response and as you can imagine it was very favourable. In the sample we had a couple of redo BYPASS patients and of course they could remember the agony of the drain removal from before so had a direct comparison.

[CCU NRS]

I had a chest tube myself after a GSW and had zero pain from removal.

I work CCU and we do many CABG's and I have assisted in hundreds of CT removals and have never had any patient do more than squirm just a little no heavy breathing, no outright wimpering, moaning, yelling, etc. I have never had an experience in which any patient has told me that CT removal was painful. We do however usually give Pt's a little MS prior to getting up to chair, or to get them to participate better with IS(incentive spirometry), usually the docs come by pretty early and the Pt's if they are having pain havce been medicated for their pain, so perhaps it is just that most have been premedicated by happenstance.

My own experience was enlightening, the removal was not painful but it is a strange feeling to suddenly be totally aware of your lung. I mean completely aware of each breath in and out feeling it like I never had before, no pain or discomfort but an acute awareness of the activity of the lung. We breath naturally day in and day out but after I had a chest tube when it was removed I had the abilty to feel that lung separate, in/out it took me about a week to actually learn to ignore the sensation.

[girloutnumbered]

I work in a cardiovascular ICU in New Zealand. We as RNs pull the chest tubes and we always give a bolus dose of (usually) Morphine prior to removal.

[girloutnumbered]

I work in a cardiovascular ICU in New Zealand. We as RNs pull the chest tubes and we always give a bolus dose of (usually) Morphine prior to removal.

[begalli]

Yes we medicate with 50mcg fentanyl IVP about 5 minutes prior to removal.