Abnormal sensations evoked over the chest and persistent peri-incisional chest pain after cardiac surgery

Acta Anaesthesiol Belg. 2010;61(2):55-62.

Abstract

Risk factors for developing Persistent peri-incisional Chest Pain (PCP) after sternotomy are multiple. We examined whether hypoesthesia, hyperalgesia or dysesthesia, evoked in the postoperative period might be associated with PCP after sternotomy. One hundred patients undergoing a sternotomy were evaluated on day 5. Peri-incisional sensory testing was performed using von Frey filament. Presence and severity of PCP were assessed at 2 and 6 months. PCP was present in 29% and 15% of patients respectively at 2 and 6 months. Hyperalgesia on day 5 was present in 43% of patients with PCP at 6 months compared to 15% without PCP. Hypoesthesia was present in 57% of patients with PCP at 6 months compared to 22% without PCP. There was no significant difference in the incidence of dysesthesia. On day 5, hyperalgesia was correlated with a risk to develop PCP at 6 months. Among sensory abnormalities, the presence of hyperalgesia is associated with PCP at 6 months postoperatively.

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / adverse effects*
  • Chest Pain / etiology*
  • Chest Pain / physiopathology
  • Coronary Artery Bypass / adverse effects
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects
  • Humans
  • Hyperalgesia
  • Male
  • Middle Aged
  • Sensation