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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, Brazil.

Brazilian Journal of Anesthesiology (Elsevier)
|June 26, 2016
PubMed
Summary

Effective pain management after sternotomy is crucial for reducing complications. A multimodal analgesic approach, combining various techniques, offers the best strategy for maximizing pain relief and minimizing side effects following heart surgery.

Keywords:
Analgesia pós-operatóriaDorEsternotomiaPainPostoperative analgesiaSternotomy

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Area of Science:

  • Cardiovascular Surgery
  • Pain Management
  • Anesthesiology

Background:

  • Sternotomy, a common heart surgery approach, frequently results in significant postoperative pain.
  • Poststernotomy pain can lead to adverse events and a notable incidence of chronic pain.
  • Effective pain control is essential for improving patient satisfaction and clinical outcomes after cardiac procedures.

Purpose of the Study:

  • To review the epidemiology, pathophysiology, prevention, and treatment of pain following sternotomy.
  • To discuss various analgesic therapeutic modalities for post-sternotomy pain.
  • To emphasize the advantages and disadvantages of each pain management technique.

Main Methods:

  • Literature review on post-sternotomy pain management strategies.
  • Analysis of different analgesic techniques, including local anesthetics, nerve blocks, opioids, NSAIDs, alpha-adrenergic agents, and neuraxial techniques.
  • Evaluation of multimodal analgesia as a combined approach.

Main Results:

  • Multiple analgesic options exist for post-sternotomy pain, including infiltration, nerve blocks, opioids, NSAIDs, alpha-adrenergic agents, and neuraxial techniques.
  • Each analgesic modality presents unique advantages and disadvantages.
  • No single technique is universally superior for managing post-sternotomy pain.

Conclusions:

  • A multimodal analgesic regimen, integrating diverse techniques, is considered the optimal strategy for managing postoperative pain after sternotomy.
  • This combined approach aims to maximize analgesia while minimizing potential side effects.
  • Effective pain management post-sternotomy is vital for enhancing patient recovery and overall surgical outcomes.