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[Pain after sternotomy - review].

Ana Paula Santana Huang1, Rioko Kimiko Sakata2

  • 1Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.

Revista Brasileira De Anestesiologia
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PubMed
Summary

Effective pain management after sternotomy is crucial for reducing complications and improving patient outcomes. A multimodal approach combining various analgesic techniques offers the best strategy for managing postoperative pain after heart surgery.

Keywords:
Analgesia pós‐operatóriaDorEsternotomiaPainPostoperative analgesiaSternotomy

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Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Pain Management

Context:

  • Sternotomy, a common heart surgery approach, frequently leads to significant postoperative pain.
  • Effective pain control post-sternotomy is essential for reducing adverse events and enhancing patient recovery.
  • Chronic pain is a non-negligible concern following sternotomy procedures.

Purpose:

  • To review the epidemiology, pathophysiology, prevention, and treatment of pain after sternotomy.
  • To discuss various analgesic modalities, highlighting the advantages and disadvantages of each.
  • To determine the optimal strategy for managing postoperative pain following heart surgery.

Summary:

  • Various analgesic techniques exist, including local anesthetic infiltration, nerve blocks, opioids, NSAIDs, alpha-adrenergic agents, and neuraxial techniques.
  • No single technique is universally superior for managing sternotomy pain.
  • A combined multimodal analgesic regimen is recommended to maximize pain relief and minimize side effects.

Impact:

  • Optimizing postoperative pain management improves patient satisfaction and clinical outcomes.
  • Comprehensive pain control can reduce the incidence of chronic pain after sternotomy.
  • Evidence-based review guides clinical practice towards effective pain management strategies.