Can chronic poststernotomy pain after cardiac valve replacement be reduced using thoracic epidural analgesia?

Acta Anaesthesiologica Scandinavica
M K Jensen, C Andersen

Abstract

The aim of our study was to evaluate the use of thoracic epidural analgesia (TEA) in acute pain management after cardiac valve replacement and determine if the incidence of chronic pain related to the sternotomy was reduced by the use of TEA. This patient group was chosen to exclude pain related to the use of the internal mammary artery and angina pectoris. Patients scheduled for elective cardiac valve replacement were offered TEA. A match-control group was selected. Epidural catheter placement, complications and postoperative neurological state were noted for both groups. Eighteen months postoperatively, a questionnaire was sent out concerning pain management, wound discomfort and pain. Forty-nine patients were included. The TEA group consisted of 35 patients. At 18 months' follow up, 37% from the TEA group and 21% from the control group had pain or discomfort related to the sternum (NS). Two in the TEA group had severe pain. We found in our small material that TEA provided excellent analgesia in the peri- and postoperative period, but we did not find a protective effect of TEA on chronic poststernotomy pain, neither weak pain nor severe pain.

References

Jan 11, 1991·The Annals of Thoracic Surgery·C E EastridgeF H Cole
Jan 1, 1991·International Journal of Cardiology·J Eng, F C Wells
Jun 1, 1986·Southern Medical Journal·L D Weber, R W Peters
Apr 1, 1985·The Annals of Thoracic Surgery·J H WoodringE P Todd
Nov 1, 1994·Acta Anaesthesiologica Scandinavica·R StensethS E Gisvold
Nov 1, 1993·The Annals of Thoracic Surgery·A J CohenF H Edwards
Mar 1, 1996·The Clinical Journal of Pain·J KatzA N Sandler
Jan 1, 1996·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R StensethS E Gisvold
Jul 20, 2001·British Journal of Anaesthesia·W A Macrae
Sep 29, 2001·Acta Anaesthesiologica Scandinavica·E KalsoE Nilsson
Sep 29, 2001·Acta Anaesthesiologica Scandinavica·J MeyersonR Karlsten
Jan 23, 2003·The Annals of Thoracic Surgery·Colin RoyseJenny Pang

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Citations

May 13, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Laura van GulikCatherijne A J Knibbe
Dec 22, 2011·British Journal of Anaesthesia·A Chandrakantan, P S A Glass
Nov 4, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Nicoline J van LeersumRobert J M Klautz
Oct 1, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Michael Mazzeffi, Yury Khelemsky
Jun 16, 2007·The Journal of Pain : Official Journal of the American Pain Society·Monique A H SteegersOliver H G Wilder-Smith
Aug 2, 2006·Acta Anaesthesiologica Scandinavica·R Pöyhiä
Mar 7, 2013·Journal of Cardiac Surgery·Burak OnanIlhan Sanisoglu
Aug 18, 2009·Acta Anaesthesiologica Scandinavica·K H GjeiloR Stenseth
Sep 25, 2017·Regional Anesthesia and Pain Medicine·Amanda M KleimanJulie L Huffmyer
Sep 16, 2018·The American Journal of Emergency Medicine·Tim MontriefBrit Long
Jun 25, 2021·Seminars in Cardiothoracic and Vascular Anesthesia·Jagan DevarajanKathirvel Subramaniam

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