Safety and patient comfort after coronary artery bypass surgery: Conventional versus single-drain – a retrospective cohort study

Gencehan Kumtepe, Hakan Güven

Abstract

Objectives: This study aimed to evaluate whether on-pump coronary artery bypass grafting (CABG) using the left internal mammary artery can be safely performed without pleural drain placement and whether this approach improves postoperative comfort by reducing pain and pulmonary complications.
Methods: A total of 207 patients who underwent elective on-pump CABG between January 2016 and December 2020 were retrospectively analysed. Patients were divided into two groups: Group I (n = 100) received a mediastinal drain only, and Group 2 (n = 107) received both a mediastinal drain and an intercostal pleural drain. Preoperative characteristics, operative variables, postoperative complications, analgesic requirements, pulmonary outcomes, and mortality were compared.
Results: Preoperative and operative variables were similar between the groups. Analgesic consumption was significantly lower in Group 1 compared to Group 2 (non-steroidal anti-inflammatory drugs: 3.04 ± 1.25 versus 3.95 ± 1.50 doses, respectively; opioids: 1.33 ± 1.29 versus 2.23 ± 1.45 doses, respectively, p < 0.001). Pulmonary complications and mortality rates were comparable between the cohorts.
Conclusion: On-pump CABG performed without pleural drain placement appears to be safe and does not increase postoperative complications, while significantly reducing analgesic requirements and improving patient comfort.