Recommendations from the Italian intersociety consensus on Perioperative Anesthesa Care in Thoracic surgery (PACTS) part 2: intraoperative and postoperative care.

The AirINTrial, which involved 500 lung resection patients, found that the incidence of prolonged air leakage (defined as still having a chest drain in place 7 days after surgery) was not significantly different in patients in whom external suction was used, compared to those without suction (10% versus 14%, respectively, P = 0.2), although a trend toward significance favoring the use of external suction was seen in patients undergoing anatomical resection (9.6% versus 16.8%, P = 0.05) (Leo et al. 2013 ).

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A meta-analysis of 27 randomized, double-blind, trials in 2314 patients undergoing major abdominal surgery, neurosurgery, or orthopedic surgery showed that ketorolac does not increase clinically significant bleeding, compared with controls (OR 1.1, 95% CI 0.61–2.06, P = 0.72); however, there appeared to be a slight trend toward more bleeding with higher doses (> 30 mg) (Gobble et al. 2014 ).

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There was also a trend toward a shorter duration of chest tube drainage with digital systems, but this did not reach statistical significance.

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