Age-related change of postoperative pain location after Nuss procedure for pectus excavatum.
OBJECTIVE
The present study aims to evaluate age-related change of postoperative pain after the Nuss procedure by referring to clinical cases, and to elucidate the biomechanical aetiology of the change by using the finite element method.


METHODS
Twelve paediatric patients (paediatric group: 9.4+/-2.3 years old) and 13 adult patients (adult group: 26.3+/-5.5 years old) who received the Nuss procedure for pectus excavatum were included in the study. On the second postoperative day, the patients were asked to indicate regions on the thorax where they felt the greatest pain. The locations of these regions were compared between the two groups. In addition, stress-distribution patterns were examined using finite element models produced by simulating the thoraces of the patients. The stress-distribution patterns were compared between the two groups.


RESULTS
The patients of the paediatric group and adult group tend to have pain on the anterior and posterior regions of the thorax, respectively. The finite element study revealed that paediatric thoraces and adult thoraces develop intensified stresses in the anterior region and the posterior region, respectively.


CONCLUSIONS
Postoperative pain tends to occur in the anterior part of the thorax for paediatric patients and in the posterior part of the thorax for adult patients, reflecting the stress distributions of these two distinct patient populations.
Nagasao
Tomohisa
T
Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan. nagasao@sc.itc.keio.ac.jp
Miyamoto
Junpei
J
Ichihara
Kazuhiko
K
Jiang
Hua
H
Jin
Hongmei
H
Tamaki
Tamotsu
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D020342:Finite Element Analysis; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D013314:Stress, Mechanical; D013909:Thorax / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult