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Ann Thorac Surg 1986;42:441-444
© 1986 The Society of Thoracic Surgeons

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Articles

Effect of Pleurotomy on Pulmonary Function After Median Sternotomy

From the Departments of Anesthesiology, Ohio State University, Columbus, OH, and the Department of Anesthesia, Northwestern University, Chicago, IL

Accepted for publication January 15, 1986.

^* Address reprint requests to Dr. Stock, Department of Anesthesiology, Emory University, 69 Butler St, SE, Atlanta, GA 30303

To determine whether pleurotomy during median sternotomy worsens postoperative pulmonary function, patients whose pleurae remained intact (N = 7) were compared with those whose pleural spaces were entered during median sternotomy (N = 31). Thirty-eight adults performed spirometry and N₂ washout to determine functional residual capacity preoperatively and 2, 24, 48, and 72 hours after extubation. Two mediastinal drainage tubes were placed in every patient; no pleural drainage tubes were inserted. Chest roentgenograms were performed preoperatively and 24 and 72 hours after extubation. Preoperatively, functional residual capacity, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and FEV₁/FVC did not differ between groups. Postoperatively, in all patients developed a restrictive pulmonary defect, but mean functional residual capacity, FVC, FEV₁, and FEV₁/FVC did not differ between groups. In contrast to earlier reports, entering the pleural space did not worsen the restrictive pulmonary defect that results from median sternotomy when direct pleural drainage was avoided.

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