title: Pain pattern and left internal mammary artery grafting.
abstract: BACKGROUND
  This study was designed to determine whether the pain pattern in patients with an internal mammary artery (IMA) harvest differs from that in other cardiac operations and whether these patients present specific characteristics with clinical implications.
  
  
  METHODS
  One hundred patients with left IMA grafting (IMA group) were compared prospectively with 100 patients who had a heart operation without IMA harvest (non-IMA group). Pain assessment was performed on postoperative days (POD) 1, 2, 3, and 7, and included pain intensity (10-point scale) and pain localization.
  
  
  RESULTS
  In the IMA group, pain intensity was higher on POD 2 (4.2 +/- 2.4 versus 3.2 +/- 2.3, p < 0.01), and there were more patients without pain on POD 7 (32 versus 19, p = 0.03). In the IMA group, more patients had left basal thoracic pain throughout the entire study period and had sternal pain on POD 7, whereas more patients in the non-IMA group complained about back pain during the early postoperative period.
  
  
  CONCLUSIONS
  The impact of IMA harvest on pain intensity is moderate, but the pain localization pattern of each group exhibits specific features that could help to better target pain management.
authors.affiliation: Clinic for Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland. xavier.mueller@chuv.hospvd.ch
authors.forename: X M
authors.initials: XM
authors.lastname: Mueller
authors.forename: F
authors.initials: F
authors.lastname: Tinguely
authors.forename: H T
authors.initials: HT
authors.lastname: Tevaearai
authors.forename: J P
authors.initials: JP
authors.lastname: Revelly
authors.forename: R
authors.initials: R
authors.lastname: Chioléro
authors.forename: L K
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D020858:Tissue and Organ Harvesting