Effect of internal mammary harvest on postoperative pain and pulmonary function.

Forty-three patients undergoing median sternotomy were evaluated for postoperative pain and pulmonary function. Group 1 (n = 26) had harvest of the internal mammary artery (IMA) and group 2 (n = 17) did not. Postoperative pain and pulmonary function were evaluated on the fifth postoperative day. Both groups showed a decrease in forced expiratory volume in 1 second (group 1, 44%; group 2, 39%), but there was no significant difference in the loss between the two groups (p = 0.32). Using a numeric rating scale, there was significant increase in postoperative pain in group 1 (group 1, 6.35; group 2, 3.82; p = 0.0002). There is a suggestion that internal mammary artery harvesting itself worsens postoperative pulmonary function tests, and this may be related to a significant increase in postoperative pain.