M K Jensen1, C Andersen. 1. Department of Cardiothoracic Anaesthesia, Odense University Hospital, Odense C, Denmark. kjaerscherer@dadlnet.dk
Abstract
BACKGROUND: The aim of our study was to evaluate the use of thoracic epidural analgesia (TEA) in acute pain management after cardiac valve replacement and determine if the incidence of chronic pain related to the sternotomy was reduced by the use of TEA. This patient group was chosen to exclude pain related to the use of the internal mammary artery and angina pectoris. METHODS: Patients scheduled for elective cardiac valve replacement were offered TEA. A match-control group was selected. Epidural catheter placement, complications and postoperative neurological state were noted for both groups. Eighteen months postoperatively, a questionnaire was sent out concerning pain management, wound discomfort and pain. RESULTS: Forty-nine patients were included. The TEA group consisted of 35 patients. At 18 months' follow up, 37% from the TEA group and 21% from the control group had pain or discomfort related to the sternum (NS). Two in the TEA group had severe pain. CONCLUSION: We found in our small material that TEA provided excellent analgesia in the peri- and postoperative period, but we did not find a protective effect of TEA on chronic poststernotomy pain, neither weak pain nor severe pain.
BACKGROUND: The aim of our study was to evaluate the use of thoracic epidural analgesia (TEA) in acute pain management after cardiac valve replacement and determine if the incidence of chronic pain related to the sternotomy was reduced by the use of TEA. This patient group was chosen to exclude pain related to the use of the internal mammary artery and angina pectoris. METHODS:Patients scheduled for elective cardiac valve replacement were offered TEA. A match-control group was selected. Epidural catheter placement, complications and postoperative neurological state were noted for both groups. Eighteen months postoperatively, a questionnaire was sent out concerning pain management, wound discomfort and pain. RESULTS: Forty-nine patients were included. The TEA group consisted of 35 patients. At 18 months' follow up, 37% from the TEA group and 21% from the control group had pain or discomfort related to the sternum (NS). Two in the TEA group had severe pain. CONCLUSION: We found in our small material that TEA provided excellent analgesia in the peri- and postoperative period, but we did not find a protective effect of TEA on chronic poststernotomy pain, neither weak pain nor severe pain.
Authors: Manon Choinière; Judy Watt-Watson; J Charles Victor; Roger J F Baskett; Jean S Bussières; Michel Carrier; Jennifer Cogan; Judy Costello; Christopher Feindel; Marie-Claude Guertin; Mélanie Racine; Marie-Christine Taillefer Journal: CMAJ Date: 2014-02-24 Impact factor: 8.262
Authors: Michael McGillion; Jennifer Yost; Andrew Turner; Duane Bender; Ted Scott; Sandra Carroll; Paul Ritvo; Elizabeth Peter; Andre Lamy; Gill Furze; Kirsten Krull; Valerie Dunlop; Amber Good; Nazari Dvirnik; Debbie Bedini; Frank Naus; Shirley Pettit; Shaunattonie Henry; Christine Probst; Joseph Mills; Elaine Gossage; Irene Travale; Janine Duquette; Christy Taberner; Sanjeev Bhavnani; James S Khan; David Cowan; Eric Romeril; John Lee; Tracey Colella; Manon Choinière; Jason Busse; Joel Katz; J Charles Victor; Jeffrey Hoch; Wanrudee Isaranuwatchai; Sharon Kaasalainen; Salima Ladak; Sheila O'Keefe-McCarthy; Monica Parry; Daniel I Sessler; Michael Stacey; Bonnie Stevens; Robyn Stremler; Lehana Thabane; Judy Watt-Watson; Richard Whitlock; Joy C MacDermid; Marit Leegaard; Robert McKelvie; Michael Hillmer; Lynn Cooper; Gavin Arthur; Krista Sider; Susan Oliver; Karen Boyajian; Mark Farrow; Chris Lawton; Darryl Gamble; Jake Walsh; Mark Field; Sandra LeFort; Wendy Clyne; Maria Ricupero; Laurie Poole; Karsten Russell-Wood; Michael Weber; Jolene McNeil; Robyn Alpert; Sarah Sharpe; Sue Bhella; David Mohajer; Sem Ponnambalam; Naeem Lakhani; Rabia Khan; Peter Liu; P J Devereaux Journal: JMIR Res Protoc Date: 2016-08-01