Persistent and acute postoperative pain after cardiac surgery with anterolateral thoracotomy or median sternotomy: A prospective observational study
| Autor: | Waseem Zakaria Aziz Zakhary, Ingrid Balga, Anna Flo Forner, Joerg Ender, Elena Korsik, Khalil Jawad, Massimiliano Meineri |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Pain Postoperative business.industry medicine.medical_treatment Incidence (epidemiology) Analgesic Chronic pain medicine.disease Sternotomy Cardiac surgery Anesthesiology and Pain Medicine Thoracotomy Median sternotomy Anesthesia Minimally invasive cardiac surgery Medicine Humans Observational study Prospective Studies Cardiac Surgical Procedures business |
| Zdroj: | Journal of clinical anesthesia. 77 |
| ISSN: | 1873-4529 |
| Popis: | The primary objective of this study was to compare the association between cardiac surgical approach (thoracotomy vs. sternotomy) and incidence of persistent postoperative pain at 3 months. Secondary objectives were the incidence and intensity of persistent pain at 6 and 12 months, acute postoperative pain, analgesic requirement and its side effects.Single-center, prospective, observational study. Recruitment between December 2017 and August 2018.Perioperative care at university-affiliated tertiary care centre.202 adults scheduled for cardiac surgery. Patients with chronic pain or behavioural disorder were excluded.Thoracotomy (n = 106) and sternotomy (n = 96).Pain scores and pain medication requirements from extubation until hospital discharge. Persistent postoperative pain was assessed using a telephone questionnaire.Incidence and intensity of pain was not significantly different between thoracotomy or sternotomy either in the short- or in the long-term follow-up. Incidence of persistent postoperative pain showed no differences between groups (30.2 vs 22.9% at 3 months (p = 0.297), 10.4 vs 7.3% at 6 months (p = 0.364) and 7.5 vs 7.3% at 12 months (p = 0.518) in thoracotomy and sternotomy group). A significant decrease of pain incidence was observed between 3 and 6 months (p 0.001) but not between 6 and 12 months (p = 0.259) in both groups. ANOVA of repeated measures adjusted for confounding variable showed a decrease of acute pain intensity over time (p = 0.001) with no difference between groups (p = 0.145). Acute pain medication requirements were not different between the groups (p = 0.237 for piritramide and p = 0.743 for oxycodone) with no difference in their side effects.Our study showed no difference in short- or long-term pain in patients undergoing anterolateral thoracotomy or median sternotomy. Both groups showed a decrease in persistent postoperative pain incidence between 3 and 6 months without any significant changes at 12 months. |
| Databáze: | OpenAIRE |
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