Chronic Pain Common After Cardiac Surgery
More than one in five patients report chronic pain after cardiac surgery, researchers announced here on April 21st at the 13th World Congress of Anaesthesiology.
Manon Choinière, PhD, University of Montréal, Montréal, Québec, Canada, presented these results from a study of 564 adults who had had undergone a first-time elective coronary bypass surgery and/ or valve replacement. All operations were performed at the Montréal Heart Institute between May 1999 and April 2002.
All subjects had completed a questionnaire sent to them a year or more after their surgery. The questionnaire was composed of standardised and validated pain measures, which included numerical Pain Intensity Rating Scale (NRS), pain interference items of the Brief Pain Inventory (BPI), the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 Health Survey (SF-36). The questionnaire also covered demographic information.
An experienced research nurse reviewed past hospital records to extract relevant medical information.
Chronic postoperative pain was defined as pain that first appeared after surgery and that differed from preoperative pain (angina pectoris) if the patient had pain before the surgery.
Overall, 22.9% of patients reported persistent non-anginal chronic postoperative pain at the time of the survey, Dr. Choinière said. More than half of these patients described their pain as moderate to severe. Chronic postoperative pain was commonly reported in more than 1 site and was most often present in the thorax.
Pain was present at least 1 day a week in 67.2% of patients. Younger patients were more likely to develop chronic pain, with an odds ratio of 0.97. Neither patient gender nor the type of surgery had an influence on the occurrence of chronic postoperative pain.
Roughly one third of patients said their pain was sufficiently intense to interfere significantly with daily activities, including sleep.
Dr. Choinière said that further research is needed to assess the exact role of adequate pain management in the early postoperative period in the transition of acute to chronic pain.
