Remifentanil during cardiac surgery is associated with chronic thoracic pain 1 yr after sternotomy
| Autor: | Peter Bruins, Sabine J.G.M. Ahlers, E.M.W. van de Garde, L. van Gulik, W. J. van Boven, Catherijne A. J. Knibbe, E. P. van Dongen, Dick Tibboel |
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| Přispěvatelé: | Pediatric Surgery |
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Care Remifentanil Intraoperative Period Double-Blind Method Piperidines Anesthesiology Risk Factors Surveys and Questionnaires Humans Medicine Prospective Studies Cardiac Surgical Procedures Prospective cohort study Aged Pain Measurement Aged 80 and over Pain Postoperative Dose-Response Relationship Drug business.industry Perioperative Odds ratio Middle Aged Sternotomy Surgery Cardiac surgery Anesthesiology and Pain Medicine ROC Curve Anesthesia Multivariate Analysis Anesthesia Intravenous Lean body mass Female Chronic Pain business Body mass index Anesthetics Intravenous Follow-Up Studies medicine.drug |
| Zdroj: | British Journal of Anaesthesia, 109(4), 616-622. Elsevier Ltd. |
| ISSN: | 0007-0912 |
| Popis: | Background Chronic thoracic pain after cardiac surgery is a serious condition affecting many patients. The aim of this study was to identify predictors for chronic thoracic pain after sternotomy in cardiac surgery patients by analysing patient and perioperative characteristics. Methods A follow-up study was performed in 120 patients who participated in a clinical trial on pain levels in the early postoperative period after cardiac surgery. The presence of chronic thoracic pain was evaluated by a questionnaire 1 yr after surgery. Patients with and without chronic thoracic pain were compared. Associations were studied using multivariable logistic regression analysis. Results Questionnaires of 90 patients were analysed. Chronic thoracic pain was reported by 18 patients (20%). In the multivariable regression model, remifentanil during cardiac surgery, age below 69 yr, and a body mass index above 28 kg m−2 were independent predictors for chronic thoracic pain {odds ratios 8.9 [95% confidence interval (CI) 1.6–49.0], 7.0 (95% CI 1.6–31.7), 9.1 (95% CI 2.1–39.1), respectively}. No differences were observed in patient and perioperative characteristics between patients receiving remifentanil (58%, n=52) compared with patients not receiving remifentanil (42%, n=38). The association between remifentanil and chronic thoracic pain appeared dose-dependent, both for total dose and for dose corrected for kilogram lean body mass and duration of surgery (P-value for trend: Conclusions In this follow-up study in cardiac surgery patients, intraoperative remifentanil was predictive for chronic thoracic pain in a dose-dependent manner. Randomized studies designed to evaluate the influence of intraoperative remifentanil on chronic thoracic pain are needed to confirm these results. |
| Databáze: | OpenAIRE |
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