Bedside diagnosis of persistent post-sternotomy pain
M-L Kalliomäki1, P Puolakka1, H Huhtala2
1Department of Anaesthesia, Tampere University Hospital, Tampere, Finland.
Acta Anaesthesiologica Scandinavica
|February 27, 2016
Summary
Persistent post-sternotomy pain (PPSP) affects 15.4% of cardiac surgery patients, characterized by sensory disturbances over the chest wall. These abnormalities are more severe and widespread in patients experiencing PPSP.
Area of Science:
- Pain Medicine
- Surgical Outcomes
- Neurology
Background:
- Persistent post-sternotomy pain (PPSP) prevalence is variable, often assessed via questionnaires.
- Cardiac surgery patients are susceptible to PPSP, impacting quality of life.
- Objective sensory examination is crucial for understanding PPSP.
Purpose of the Study:
- To systematically evaluate sensory disturbances in patients with PPSP.
- To quantitatively assess the characteristics of PPSP.
- To differentiate PPSP patients from those without pain post-sternotomy.
Main Methods:
- A cohort of 100 patients undergoing coronary artery bypass grafting via sternotomy were assessed 4-6 months post-surgery.
- Dynamic sensory mapping included thermal testing, tactile assessment, and pinprick evaluation.
- Pain intensity, sensory dysfunction area, and daily activity were evaluated using validated tools.
Main Results:
- 15.4% of patients (13/90) were diagnosed with PPSP.
- Sensory abnormalities were present in 69% of all patients, more pronounced in the PPSP group.
- PPSP patients exhibited greater sensory dysfunction extent and poorer daily activity performance.
Conclusions:
- PPSP is a clinical diagnosis readily made with history and simple sensory tests.
- The severity and extent of sensory abnormalities correlate with PPSP.
- Objective sensory mapping aids in diagnosing and characterizing PPSP.
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