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Pain location and intensity during the first week following coronary artery bypass graft surgery
Ziae Totonchi1, Somayeh Seifi1, Mitra Chitsazan1
1Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
Post-coronary artery bypass grafting (CABG) pain is most severe at the surgical incision around day two. Pain intensity decreases by day three, influenced by factors like age, BMI, and operation duration.
Area of Science:
- Cardiovascular Surgery
- Pain Management
- Postoperative Care
Background:
- Limited data exists on the location and distribution of postoperative pain following coronary artery bypass grafting (CABG).
- Understanding pain patterns is crucial for improving patient recovery and pain management strategies after cardiac surgery.
Purpose of the Study:
- To investigate the location, distribution, and intensity of pain in patients undergoing CABG.
- To analyze factors influencing pain intensity and distribution during the postoperative hospital stay.
Main Methods:
- 138 patients undergoing CABG were assessed using a numeric rating scale (NRS).
- Pain was evaluated at multiple time points from operation up to seven days post-operation (POD7).
- Factors analyzed included age, sex, BMI, cardiopulmonary bypass duration, chest tube drainage, and ICU stay.
Main Results:
- Peak pain severity occurred at T2 (day 1, 6 hours post-op), with the surgical incision being the primary pain location.
- Pain intensity decreased from the third postoperative day.
- Factors such as age, sex, BMI, cardiopulmonary bypass duration, chest tube drainage, and ICU stay duration significantly correlated with pain severity.
Conclusions:
- Post-CABG pain is most intense at the surgical incision around T2 and generally decreases after the third postoperative day.
- Patient demographics (age, sex, BMI) and operative factors (cardiopulmonary bypass duration, chest tube drainage, ICU stay) influence the postoperative pain profile.
Background:
Despite the advances in pain control following surgery, data on the location and distribution of pain following coronary artery bypass grafting (CABG) are lacking.
Objectives:
This study was intended to investigate the location, distribution, and intensity of pain in patients undergoing CABG during their postoperative hospital stay from the operation to the end of the first postoperative week. Factors that could affect pain intensity and distribution were analyzed as well.
Patients And Methods:
The present study was conducted on 138 patients who underwent CABG surgery at Rajaei cardiovascular, Medical and Research Center during May and July 2011. Location and intensity of pain were assessed using numeric rating scale (NRS) over time: every six hours after the operation on the first day (T1-T4, respectively), and on two (POD2), three (POD3), and seven days after the operation (POD7).
Results:
Among 138 patients assessed in the study, the greatest severity of pain was reported on T2, with the mean severity of 3.4, followed by POD2 with the mean severity of 2.9 (P < 0.01). The location of the surgical incision had the most severity of pain in all patients (P < 0.01). On the site of surgical incision, a negative correlation was seen between the age and the severity of pain on T1 (P = 0.03, r = -0.180). Women experienced more severe pain compared to men at POD7. A significant correlation was seen between the severity of pain on POD7 and body mass index (BMI) (P < 0.01, r = 0.23). In patients who had the longer duration of cardiopulmonary bypass (CBD), the most pain intensity was reported on T1 (P < 0.01, r = 0.18). A significant correlation was seen on the pain intensity on T4 and chest tube drainage (P < 0.01, r = 0.24). The correlation between the pain severity pain and duration of admission in intensive care unit (ICU), was significant on T1 (P < 0.05, r = 0.18), T4 (P < 0.01, r = 0.29), POD2 (P < 0.01, r = 0.35) and POD7 (P < 0.05, r = 0.18).
Conclusions:
Following CABG, the most severity of pain was reported at surgical incision on time T2. Pain began to decrease from the third day following the operation. Age, sex and BMI along with operation-related factors such as duration of CBP or chest tube drainage may affect the pain pattern following CABG surgery.
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