Dysaesthesia associated with sternotomy for heart surgery
1Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK. peter.alston@ed.ac.uk
British Journal of Anaesthesia
|May 17, 2005
Summary
Dysaesthesia, altered skin sensation, is common after cardiac surgery. It is linked to coronary artery bypass graft surgery and severe pain, suggesting a neuropathic origin.
Area of Science:
- Pain Medicine
- Neurosurgery
- Cardiothoracic Surgery
Background:
- Chronic pain affects 40-50% of patients post-cardiac surgery.
- Dysaesthesia, a change in skin sensation, is linked to neuropathic pain.
- Early detection of dysaesthesia may predict chronic pain development.
Purpose of the Study:
- Investigate the incidence, extent, and causes of dysaesthesia after sternotomy.
- Understand the characteristics of early postoperative dysaesthesia.
Main Methods:
- Prospective cohort study of 50 patients undergoing sternotomy for cardiac surgery.
- Assessed acute pain using a verbal scale 48 hours post-operation.
- Detected dysaesthesia areas using pinprick and cotton wool tests.
Main Results:
- Dysaesthesia occurred in 54% of patients (27 out of 50).
- Total dysaesthesia area correlated with coronary artery bypass graft (CABG) surgery.
- Dysaesthesia extent was associated with increased postoperative pain severity.
Conclusions:
- Dysaesthesia is prevalent in the early period after sternotomy for cardiac surgery.
- Dysaesthesia is associated with CABG surgery.
- Pain severity link suggests a neuropathic component potentially unrelieved by opioids.
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