Email this article Chronic post-thoracotomic pain syndrome in cardiothoracic surgery after minimally invasive coronary bypass surgery: prospective cohort study
- Authors: Stukalov A.V.1, Lakhin R.E.1, Gritsai A.N.1, Ershov E.N.1, Stukalov N.V.1, Garbuzov E.Y.2
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Affiliations:
- Kirov Military Medical Academy
- City hospital No. 40
- Issue: Vol 16, No 4 (2022)
- Pages: 279-288
- Section: Original articles
- URL: https://journals.rcsi.science/1993-6508/article/view/131773
- DOI: https://doi.org/10.17816/RA112304
- ID: 131773
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Abstract
BACKGROUND: No consensus has been established on the role of epidural anesthesia in relation to the prevention of chronic post-thoracotomic pain during minimally invasive coronary bypass surgery.
OBJECTIVE: This study aimed to evaluate the effect of epidural anesthesia on the incidence of chronic post-thoracotomic pain syndrome after minimally invasive direct coronary artery bypass (MIDCAB) surgery.
MATERIALS AND METHODS: The study included 87 patients who underwent MIDCAB surgery. In group 1, epidural anesthesia was performed before the induction of general anesthesia; in group 2, the operation was performed only under general anesthesia.
RESULTS: The use of fentanyl for anesthesia varied: 0.5 (0.5; 0.6) mg in group 1 versus 3.5 (3.3; 3.6) mg in group 2 (p <0.01). The incidence of chronic post-thoracotomic pain in patients 3 months after surgery was higher in group 2 than in group 1 (39.1% vs 17.2%, p=0.005). The severity of pain at rest was 3 points (2; 3) in group 1 and 3 points (3; 3.5) in group 2 (p=0.018); however, during a deep breath, these differences became insignificant: 4 points (4; 4) in group 1 and 4 (4; 5) points in group 2 (p=0.453). At 6 months after surgery, chronic post-thoracotomic pain was present in 15.6% of the patients in group 1 and 34.8% in group 2 (p=0.011). After 6 months, the severity of pain at rest was 2.5 (2; 3) in group 1 and 3 (3; 3.75) in group 2 (p=0.01). No differences in cough were found: 4 (3.75; 4) points in group 1 and 4 (4; 4.5) points in group 2 (p >0.05).
CONCLUSION: The use of epidural anesthesia led to a decrease in the incidence of chronic post-thoracotomic pain in patients undergoing MIDCAB surgery.
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##article.viewOnOriginalSite##About the authors
Anatoliy V. Stukalov
Kirov Military Medical Academy
Author for correspondence.
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0002-3869-9043
SPIN-code: 9636-6856
researcher
Russian Federation, St. PetersburgRoman E. Lakhin
Kirov Military Medical Academy
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0001-6819-9691
SPIN-code: 7261-9985
MD, Dr. Sci. (Med.), associate professor
Russian Federation, St. PetersburgAlexander N. Gritsai
Kirov Military Medical Academy
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0001-5909-7810
SPIN-code: 6756-7894
MD, Cand. Sci. (Med.)
Russian Federation, St. PetersburgEugene N. Ershov
Kirov Military Medical Academy
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0002-9572-6802
SPIN-code: 1837-5183
MD, Cand. Sci. (Med.)
Russian Federation, St. PetersburgNikolay V. Stukalov
Kirov Military Medical Academy
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0001-7928-2132
SPIN-code: 9213-4640
clinical resident
Russian Federation, St. PetersburgEvgenii Yu. Garbuzov
City hospital No. 40
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0003-2990-0320
department head, anesthesiologist-resuscitator
Russian Federation, St. PetersburgReferences
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