Pain after median sternotomy: collateral damage or mitigatable byproduct?

Thorac Cardiovasc Surg. 2013 Apr;61(3):194-201. doi: 10.1055/s-0032-1311540. Epub 2012 Nov 6.

Abstract

Background: Postoperative acute pain can cause anxiety and decrease the quality of life in patients. Acute sternal bone pain after cardiac surgery can persist for long time.

Objective: The aim of this study is to explore the relationships between the degree of sternal misalignment and the degree of acute sternal pain after coronary artery bypass grafting surgery (CABG).

Methods: We retrospectively reviewed postoperative coronary computed tomographic (CT) angiography and medical records in 104 patients who received CABG between May 1, 2009 and January 31, 2011. CT scan was classified into five categories, and we compared the degree of misalignment and subjective pain via numerical rating scale (NRS) system.

Results: Positive correlation was noted between NRS and the degree of sternal misalignment (Pearson correlation coefficient 0.660, p = 0.000).

Conclusion: Postoperative sternal pain is related to the degree of misalignment of the sternal halves. It would be appropriate for surgeons to approximate the sternal halves accurately to decrease the postoperative sternal wound pain in the first place.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods
  • Coronary Artery Disease / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology*
  • Retrospective Studies
  • Severity of Illness Index
  • Sternotomy / adverse effects*
  • Surgical Wound Dehiscence / complications*
  • Surgical Wound Dehiscence / diagnosis
  • Tomography, X-Ray Computed