Intraoperative partial spray of 50% glucose effectively prevents recurrence and complications in pneumothorax
Pneumothorax patients require surgical intervention, but recurrences are common postoperatively. Thoracic surgeons experimented with techniques like pleural abrasion, chemical pleurodesis, staple line coverage with absorbable sheets, and bullectomy to decrease these recurrences. Recently, the effectiveness of using intraoperative glucose intrapleural spray (GIS) containing 50 ml of 50% glucose solution in addition to bullectomy has been reported. However, information on the effects and adverse events of GIS is limited.
A study published in the Journal of Cardiothoracic Surgery concluded that intraoperative glucose intrapleural spray is safe and effective in preventing recurrences and postoperative complications.
This study assessed the efficacy and safety of GIS in preventing recurrence of pneumothorax. Researchers analyzed 74 cases of bullectomy, including those with/without GIS, at Okazaki City Hospital (2018 to 2021). Among these, 50 underwent GIS treatment, while 24 were treated conservatively.
Key findings from the study are:
- The GIS group comprised 46 males and only four females, while the C group had 23 males and a single female. The respective mean ages of the groups were 38.5 ± 5.7 years and 30.5 ± 6.7 years.
· The GIS group exhibited a mean increase in blood glucose of 23.8 mg/dL postoperatively.
· Two cases in the GIS group (4.0%) and two in the C group (8.3%) had postoperative infections.
· In the GIS group and the C group, the NRS scores of the patients three hours postoperatively were 4.0 and 3.1, respectively.
· No prolonged postoperative drainage period was observed by GIS (1.2 days and 1.4 days in the GIS and C groups, respectively).
· two patients in the C group had postoperative recurrence.
· In the GIS and C groups, postoperative total drainage volumes were 341.8 ± 25.2 ml and 74.2 ± 25.5 ml, respectively, significantly increasing drainage volume.
· None of them presented dehydration-related symptoms.
The safety and efficacy of using intraoperative glucose intrapleural spray have been established in this study to prevent recurrences and postoperative complications.
It is especially important to inform and educate nail technicians about the risks of ACD and the preventive measures that can be taken to reduce the likelihood of its occurrence.
Reference:
Kiriyama, Ryota, et al. "Efficacy and Safety of Intraoperative Partial Spray of 50% Glucose for Patients With Spontaneous Pneumothorax." Journal of Cardiothoracic Surgery, vol. 19, no. 1, 2024, p. 14.
