Assessment and pathophysiology of pain in cardiac surgery

Abstract

Marek Zubrzycki,1 Andreas Liebold,1 Christian Skrabal,1 Helmut Reinelt,2 Mechthild Ziegler,2 Ewelina Perdas,3 Maria Zubrzycka3 1Department of Cardiac Surgery, University of Ulm Medical Center, Ulm, Germany; 2Department of Cardiac Anesthesiology, University of Ulm Medical Center, Ulm, Germany; 3Department of Cardiovascular Physiology, Medical University of Lodz, Lodz, Poland Abstract: Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain. Ineffective postoperative analgesic therapy may cause several complications that are dangerous to a patient. Inappropriate postoperative pain management may result in chronic pain, immunosuppression, infections, and less effective wound healing. Understanding and better knowledge of physiological disorders and adverse effects resulting from surgical trauma, anesthesia, and extracorporeal circulation, as well as the development of standards for intensive postoperative care units are critical to the improvement of early treatment outcomes and patient comfort. Keywords: cardiac surgery, postoperative pain, pain intensity, analgesics

Keywords

• cardiac surgery
• postoperative pain
• pain intensity
• analgesics