Revista Brasileira de Anestesiologia (Aug 2016)

Pain after sternotomy - review

  • Ana Paula Santana Huang,
  • Rioko Kimiko Sakata

DOI
https://doi.org/10.1016/j.bjane.2014.09.013
Journal volume & issue
Vol. 66, no. 4
pp. 395 – 401

Abstract

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Abstract Background and objective: Adequate analgesia after sternotomy reduces postoperative adverse events. There are various methods of treating pain after heart surgery, such as infiltration with a local anesthetic, nerve block, opioids, non-steroidal anti-inflammatory drugs, alpha-adrenergic agents, intrathecal and epidural techniques, and multimodal analgesia. Content: A review of the epidemiology, pathophysiology, prevention and treatment of pain after sternotomy. We also discuss the various analgesic therapeutic modalities, emphasizing advantages and disadvantages of each technique. Conclusions: Heart surgery is performed mainly via medium sternotomy, which results in significant postoperative pain and a non-negligible incidence of chronic pain. Effective pain control improves patient satisfaction and clinical outcomes. There is no clearly superior technique. It is believed that a combined multimodal analgesic regimen (using different techniques) is the best approach for treating postoperative pain, maximizing analgesia and reducing side effects.

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