Incidence of Postsurgical Hypoaesthesia Following Major Thoraco-abdominal Surgeries: A Prospective Observational...

Major thoraco-abdominal onco-surgeries are integral part of cancer treatment. During surgery, the nerves supplying anterior chest/ abdominal wall are likely to be injured, leading to hypoaesthesia. In view of limited literature, this observational study was planned to note the incidence of hypoaesthesia. It's association with various surgical incisions, diabetes, prior chemotherapy and use of regional techniques was analysed. This prospective cross-sectional study was initiated after IEC approval and CTRI registration. Eligible consenting adult patients planned for thoraco- abdominal surgeries were screened pre-operatively for sensations over entire chest and abdomen. Patients with positive hypoaesthetic/ altered sensations patches pre-operatively were excluded from the study. Patients with normal examination finding were included in the trial and the clinical test was repeated post-surgery on post operative day 4/5. Development of new hypoaesthestic patch, post-surgery was notified to the patient and primary unit; the patient and relatives were counselled about basic care to avoid future complications. Repeat examination was done at 4-8 weeks post-surgery. Hundred and eighty patients were included in the study, 15 percent of patients had peri-incisional hypoesthesia. Hypoesthesia  was associated with certain type of incisions [subcostal (70%), Makuuchi (25%), Midline sternotomy (20%), Lateral thoracotomy (15%)]. No association was seen between diabetes, chemotherapy, comorbidity and postsurgical hypoesthesia. Postsurgical hypoesthesia persisted on the follow-up at 4-8 weeks. The incidence of surgical hypoesthesia in our study group was 15%. Incidence of postsurgical hypaesthesia varied with the type of incision and is most commonly associated with subcostal incisions. Immediate recovery of hypoesthesia (within 4-8 weeks) is unlikely as seen in this study.