A survey of post‐sternotomy chronic pain following cardiac surgery

Carle, Coralie; Ashworth, Alan; Roscoe, Andrew

doi:10.1111/j.1365-2044.2009.06169_1.x

Cited by 13 publications

(7 citation statements)

References 2 publications

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“…However, patients suffer from pain in the shoulders and lower legs that have undergone surgical intervention (vein extraction), which in turn may be associated with increased motor activity and spasticity of shoulder muscles stretched by thoracic dilatation during surgery. 13 , 66 The pain is described as chest discomfort of noncardiac origin in up to 65% of cases, and can coexist with pain in the upper extremities, neck, head, and mid-back area. 67 …”

Section: Location Of Acute Pain After Cardiac Surgerymentioning

confidence: 99%

Assessment and pathophysiology of pain in cardiac surgery

Zubrzycki¹,

Liebold²,

Skrabal³

et al. 2018

JPR

132

106

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Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain. Ineffective postoperative analgesic therapy may cause several complications that are dangerous to a patient. Inappropriate postoperative pain management may result in chronic pain, immunosuppression, infections, and less effective wound healing. Understanding and better knowledge of physiological disorders and adverse effects resulting from surgical trauma, anesthesia, and extracorporeal circulation, as well as the development of standards for intensive postoperative care units are critical to the improvement of early treatment outcomes and patient comfort.

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Section: Location Of Acute Pain After Cardiac Surgerymentioning

confidence: 99%

Assessment and pathophysiology of pain in cardiac surgery

Zubrzycki¹,

Liebold²,

Skrabal³

et al. 2018

JPR

132

106

View full text Add to dashboard Cite

show abstract

“…Sources of pain after cardiac surgery with median sternotomy include the sternotomy incision, chest tubes, the pericardial drainage, the site of saphenous vein, or radial artery harvesting [2, 3]. The pain is described as chest discomfort of noncardiac origin in up to 65% of cases and can coexist with pain in the upper extremities, neck, head, and midback area [4].…”

Section: Introductionmentioning

confidence: 99%

“…Acute postsurgical pain and the possible progression to chronic postsurgical pain (CPSP) can influence patients' immediate and late postoperative course after cardiac surgery [ 1 ]. Sources of pain after cardiac surgery with median sternotomy include the sternotomy incision, chest tubes, the pericardial drainage, the site of saphenous vein, or radial artery harvesting [ 2 , 3 ]. The pain is described as chest discomfort of noncardiac origin in up to 65% of cases and can coexist with pain in the upper extremities, neck, head, and midback area [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

Bouzia¹,

Tassoudis

Καρανικόλας

et al. 2017

Anesthesiology Research and Practice

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Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75 mg, and Group 3 received oral pregabalin 150 mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively. Results. Patients receiving pregabalin required fewer morphine boluses (10 in controls versus 6 in Group 1 versus 4 in Group 2, p = 0.000) and had lower pain scores at 8 hours (4 versus 3 versus 3, p = 0.001) and 3 months (3 versus 2 versus 2, p = 0.000) and lower morphine consumption at 8 hours (14 versus 13 versus 12 mg, p = 0.000) and 24 hours (19.5 versus 16 versus 15 mg, p = 0.000). Percentage of patients with sleep disturbances or requiring analgesics was lower in the pregabalin group and even lower with higher pregabalin dose (16/31 versus 5/31 versus 3/31, p = 0.000, and 26/31 versus 16/31 versus 10/31, p = 0.000, resp.) 3 months after surgery. Conclusion. Preoperative oral pregabalin 75 or 150 mg reduces postoperative morphine requirements and acute and chronic pain after cardiac surgery.

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“…In many circumstances, small complications such as chronic wound pain or numbness can be omitted easily during the consent process, leading to increased patient anxiety following surgery [8]. Our findings indicate that the use of a modified pre-printed consent form ensures that all relevant major or common complications are included during the surgical explanation, allowing consent to be provided in a truly informed manner.…”

Section: Discussionmentioning

confidence: 90%

DNA methylation confers clinical potential to predict the oral cancer prognosis

Yang¹,

Wu²,

Chang³

et al. 2018

Clin Res Trial

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Background: Patient understanding is a fundamental requirement for the consent process, yet current UK Department of Health consent forms rely on handwritten explanations on admission prior to cardiac surgery. A pre-printed consent form containing pertinent information about the planned procedure and its associated benefits/risks may benefit in patient retention of information.Trial design: Randomised study using a pre-test/post-test design in which participants completed a questionnaire prior to providing consent and following surgery.Methods: 100 patients scheduled for coronary artery bypass surgery were recruited and randomised by computer into two groups receiving either the current standard handwritten consent form (group 1) or a modified pre-printed consent form (group 2).Objective: To assess whether a standardised, pre-printed consent form improves patient information retention and experience of the consent process.Results: No significant differences in demographics or pre-consent questionnaire data were observed between groups. A greater proportion of patients could identify (62.0% vs. 30.0%, p=0.011) and understand their surgical procedure (66.0% vs. 20.0%, p=0.001) in group 2 compared to group 1. Group 2 exhibited greater understanding of the benefits (72.0% vs. 8.0%, p<0.001) and risks (82.0% vs. 10.0%, p<0.001) of the surgery and indicated greater satisfaction with the consent process post-operatively (94.29% vs. 85.22%, p<0.001) compared to group 1. Conclusion:This study highlights the importance of a written explanation on the consent form, which encourages greater patient understanding and aids in shared decision making between the surgical team and the patient.

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A survey of post‐sternotomy chronic pain following cardiac surgery

Cited by 13 publications

References 2 publications

Assessment and pathophysiology of pain in cardiac surgery

Assessment and pathophysiology of pain in cardiac surgery

Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

DNA methylation confers clinical potential to predict the oral cancer prognosis

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