Risk factors for chronic thoracic pain after cardiac surgery via sternotomy

Abstract

We have identified a number of factors correlated with persistent thoracic pain following cardiac surgery with sternotomy. Awareness of these predictors may be useful for further research concerning both the prevention and treatment of chronic thoracic pain, thereby potentially ameliorating the postoperative quality of life of a significant proportion of patients. Meanwhile, chronic thoracic pain should be discussed preoperatively with patients at risk so that they are truly informed about possible consequences of the surgery.

Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study

“…Clinicians' lack of familiarity with the prevalence or potential treatments of persistent postoperative pain may result in no or deficient pain management. 26 Consistent with observations made in cardiac 14,22 and noncardiac surgery patient cohorts, [1][2][3]24 we showed that the intensity of acute postoperative pain was a significant predictor of both the presence and the severity of persistent postoperative pain. Irrespective of study sites, patients with higher ratings for acute pain and interference with daily functioning in the first week after surgery were more likely to report persistent postoperative pain at 24 months.…”

“…As in previous studies in the cardiac surgery field, 9,14,19,22,36 we defined acute and persistent postScreened for eligibility n = 1439…”

“…13,14,21,22,25 All of the above studies were carried out in a single hospital and included relatively small samples. None of the studies examined the contribution of psychological factors such as levels of anxiety and depression before cardiac surgery, although these factors have been shown to influence acute or persistent postoperative pain in other types of surgery.…”

“…However, persistent postoperative pain of nonanginal origin has been reported in 7% to 60% of patients following these surgeries. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Such variability is common in other types of major surgery and is due mainly to differences in the definition of persistent postoperative pain, study design, data collection methods and duration of follow-up. [1][2][3]24 Few prospective cohort studies have examined the exact time course of persistent postoperative pain after cardiac surgery, and follow-up has always been limited to a year or less.…”

The Five Diaphragms in Patients Following Cardiac Surgery in Sternotomy: An Observational Study

“…It is estimated that each year over two million people worldwide undergo heart surgery in sternotomy, a surgical procedure which is not without iatrogenic complications [1,2]. These complications increase morbidity and mortality rates, slowing down the recovery process in patients [2].…”