Dysaesthesia associated with sternotomy for heart surgery
Background. Chronic pain occurs in 40–50% patients following cardiac surgery. Dysaesthesia, either in the form of heightened or diminished skin sensation, are frequently associated with chronic neuropathic pain. Therefore, dysaesthesia in the early postoperative period may predict chronic pain. Howe...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2005-08, Vol.95 (2), p.153-158 |
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| description | Background. Chronic pain occurs in 40–50% patients following cardiac surgery. Dysaesthesia, either in the form of heightened or diminished skin sensation, are frequently associated with chronic neuropathic pain. Therefore, dysaesthesia in the early postoperative period may predict chronic pain. However, the character and causes of dysaesthesia in the early postoperative period are unknown. The aim of this study was to investigate the incidence, extent, and causes of dysaesthesia following cardiac surgery by sternotomy. Methods. In a prospective cohort study, 50 patients undergoing sternotomy for cardiac surgery were admitted to the study: 38 underwent coronary artery bypass graft (CABG), nine valve surgery, and three combined surgery. Forty-eight hours postoperatively, acute pain was measured by four-point verbal scale. Manual pinprick and cotton wool brushing was used to detect the areas of dysaesthesia. Results. Some form of dysaesthesia was found in 27 (54%) of the patients. Using multivariate regression analysis, the total area of dysaesthesia was positively associated with CABG surgery and the severity of postoperative pain (P |
| doi_str_mv | 10.1093/bja/aei152 |
| format | Article |
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P. ; Pechon, P.</creator><creatorcontrib>Alston, R. P. ; Pechon, P.</creatorcontrib><description>Background. Chronic pain occurs in 40–50% patients following cardiac surgery. Dysaesthesia, either in the form of heightened or diminished skin sensation, are frequently associated with chronic neuropathic pain. Therefore, dysaesthesia in the early postoperative period may predict chronic pain. However, the character and causes of dysaesthesia in the early postoperative period are unknown. The aim of this study was to investigate the incidence, extent, and causes of dysaesthesia following cardiac surgery by sternotomy. Methods. In a prospective cohort study, 50 patients undergoing sternotomy for cardiac surgery were admitted to the study: 38 underwent coronary artery bypass graft (CABG), nine valve surgery, and three combined surgery. Forty-eight hours postoperatively, acute pain was measured by four-point verbal scale. Manual pinprick and cotton wool brushing was used to detect the areas of dysaesthesia. Results. Some form of dysaesthesia was found in 27 (54%) of the patients. Using multivariate regression analysis, the total area of dysaesthesia was positively associated with CABG surgery and the severity of postoperative pain (P<0.001). Conclusion. Dysaesthesia is common in the early postoperative period following cardiac surgery using a sternotomy and is associated with CABG surgery. The association with severity of pain may indicate a neuropathic element that is unrelieved by conventional opioid analgesia.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aei152</identifier><identifier>PMID: 15894562</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Affect ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Chest Pain ; Chronic Disease ; chronic neuropathic ; complications ; Female ; Heart Valve Prosthesis Implantation ; Humans ; hyperalgesia ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; neuropathy ; pain ; Pain, Postoperative - etiology ; Paresthesia - etiology ; Paresthesia - psychology ; Prospective Studies ; Sensory Thresholds ; Sternum - surgery ; surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>British journal of anaesthesia : BJA, 2005-08, Vol.95 (2), p.153-158</ispartof><rights>The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org 2005</rights><rights>2005 INIST-CNRS</rights><rights>Copyright British Medical Association Aug 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16976574$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15894562$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alston, R. P.</creatorcontrib><creatorcontrib>Pechon, P.</creatorcontrib><title>Dysaesthesia associated with sternotomy for heart surgery</title><title>British journal of anaesthesia : BJA</title><addtitle>Br. J. Anaesth</addtitle><addtitle>Br. J. Anaesth</addtitle><description>Background. Chronic pain occurs in 40–50% patients following cardiac surgery. Dysaesthesia, either in the form of heightened or diminished skin sensation, are frequently associated with chronic neuropathic pain. Therefore, dysaesthesia in the early postoperative period may predict chronic pain. However, the character and causes of dysaesthesia in the early postoperative period are unknown. The aim of this study was to investigate the incidence, extent, and causes of dysaesthesia following cardiac surgery by sternotomy. Methods. In a prospective cohort study, 50 patients undergoing sternotomy for cardiac surgery were admitted to the study: 38 underwent coronary artery bypass graft (CABG), nine valve surgery, and three combined surgery. Forty-eight hours postoperatively, acute pain was measured by four-point verbal scale. Manual pinprick and cotton wool brushing was used to detect the areas of dysaesthesia. Results. Some form of dysaesthesia was found in 27 (54%) of the patients. Using multivariate regression analysis, the total area of dysaesthesia was positively associated with CABG surgery and the severity of postoperative pain (P<0.001). Conclusion. Dysaesthesia is common in the early postoperative period following cardiac surgery using a sternotomy and is associated with CABG surgery. The association with severity of pain may indicate a neuropathic element that is unrelieved by conventional opioid analgesia.</description><subject>Adult</subject><subject>Affect</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiopulmonary Bypass</subject><subject>Chest Pain</subject><subject>Chronic Disease</subject><subject>chronic neuropathic</subject><subject>complications</subject><subject>Female</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>hyperalgesia</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>neuropathy</subject><subject>pain</subject><subject>Pain, Postoperative - etiology</subject><subject>Paresthesia - etiology</subject><subject>Paresthesia - psychology</subject><subject>Prospective Studies</subject><subject>Sensory Thresholds</subject><subject>Sternum - surgery</subject><subject>surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0U1PGzEQBmALFZUAvfQHVKtKcFvwrD_Ge2z5liKBELQRF2uy622cJtnU3hXk32OUlEic5jCPRjPzMvYV-AnwUpyOp3RKzoMqdtgAJEKuEeETG3DOMeclFHtsP8Yp54BFqT6zPVCmlEoXA1aeryK52E1c9JRRjG3lqXN19uy7SRY7FxZt185XWdOGbOIodFnswx8XVodst6FZdF829YA9Xl48nF3nw9urm7Mfw9wLIbu8McJwLUSlJZJBNXZkyrqp0YE2ZKSonEClDBRc6gZqHAPVqc8brmQFKA7Y8XruMrT_-rSqnftYudmMFq7to9WGgwSjE_z-AU7bPizSbhZKRFUYaRL6tkH9eO5quwx-TmFl_38kgaMNoFjRrAm0qHzcOl2iVii3ru2X2y63b4nYlIhdJ5JcvnY-PfPlXVL4azWmy-316Mne_7oDHP0u7E_xCm03igs</recordid><startdate>20050801</startdate><enddate>20050801</enddate><creator>Alston, R. P.</creator><creator>Pechon, P.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20050801</creationdate><title>Dysaesthesia associated with sternotomy for heart surgery</title><author>Alston, R. P. ; Pechon, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i334t-f8380633c647a875bea89dfd7e168a843ce3755812046f1d7b1addfd0f054c173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Affect</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiopulmonary Bypass</topic><topic>Chest Pain</topic><topic>Chronic Disease</topic><topic>chronic neuropathic</topic><topic>complications</topic><topic>Female</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Humans</topic><topic>hyperalgesia</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>neuropathy</topic><topic>pain</topic><topic>Pain, Postoperative - etiology</topic><topic>Paresthesia - etiology</topic><topic>Paresthesia - psychology</topic><topic>Prospective Studies</topic><topic>Sensory Thresholds</topic><topic>Sternum - surgery</topic><topic>surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alston, R. P.</creatorcontrib><creatorcontrib>Pechon, P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alston, R. P.</au><au>Pechon, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dysaesthesia associated with sternotomy for heart surgery</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>Br. J. Anaesth</stitle><addtitle>Br. J. Anaesth</addtitle><date>2005-08-01</date><risdate>2005</risdate><volume>95</volume><issue>2</issue><spage>153</spage><epage>158</epage><pages>153-158</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>Background. Chronic pain occurs in 40–50% patients following cardiac surgery. Dysaesthesia, either in the form of heightened or diminished skin sensation, are frequently associated with chronic neuropathic pain. Therefore, dysaesthesia in the early postoperative period may predict chronic pain. However, the character and causes of dysaesthesia in the early postoperative period are unknown. The aim of this study was to investigate the incidence, extent, and causes of dysaesthesia following cardiac surgery by sternotomy. Methods. In a prospective cohort study, 50 patients undergoing sternotomy for cardiac surgery were admitted to the study: 38 underwent coronary artery bypass graft (CABG), nine valve surgery, and three combined surgery. Forty-eight hours postoperatively, acute pain was measured by four-point verbal scale. Manual pinprick and cotton wool brushing was used to detect the areas of dysaesthesia. Results. Some form of dysaesthesia was found in 27 (54%) of the patients. Using multivariate regression analysis, the total area of dysaesthesia was positively associated with CABG surgery and the severity of postoperative pain (P<0.001). Conclusion. Dysaesthesia is common in the early postoperative period following cardiac surgery using a sternotomy and is associated with CABG surgery. The association with severity of pain may indicate a neuropathic element that is unrelieved by conventional opioid analgesia.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>15894562</pmid><doi>10.1093/bja/aei152</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Affect Aged Aged, 80 and over Biological and medical sciences Cardiac Surgical Procedures Cardiopulmonary Bypass Chest Pain Chronic Disease chronic neuropathic complications Female Heart Valve Prosthesis Implantation Humans hyperalgesia Male Medical sciences Middle Aged Multivariate Analysis neuropathy pain Pain, Postoperative - etiology Paresthesia - etiology Paresthesia - psychology Prospective Studies Sensory Thresholds Sternum - surgery surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Dysaesthesia associated with sternotomy for heart surgery |
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