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Dysaesthesia associated with sternotomy for heart surgery.

R P Alston1, P Pechon

  • 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
PubMed
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.

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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.

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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.