Pain symptoms accompanying chronic poststernotomy pain: a pilot study.
OBJECTIVE
Despite the technical developments in surgical procedures, chronic poststernotomy pain (CPSP) is still very common. Many theories for its cause have been proposed in the literature, but the etiology is still not clear. Pain along the sternal scar and in the upper extremities (sometimes accompanied with paresthesia) persists in about 30% of cases. These symptoms have been regarded as two separate complications. This study investigated all pain symptoms in patients following sternotomy.


METHODS
Retrospective pilot study.


METHODS
Outpatient clinic at the Leiden University Medical Center.


METHODS
A cohort of patients who underwent open heart surgery by median sternotomy between January 1, 2004 and January 1, 2006.


METHODS
A questionnaire was completed by 631 patients, and a selected sample of 277 patients was examined for pain of the head, neck, back, and chest and upper extremities.


METHODS
All pain locations were compared in two groups: 189 patients with sternal pain and 88 patients without sternal pain.


RESULTS
We found that pain and muscular tenderness in the investigated areas unrelated to the chest wall incision were significantly more common in patients with sternal pain compared to the nonsternal pain group. No surgical or demographic factors with the exception of female gender were consistent predictors of sternal pain.


CONCLUSIONS
CPSP is an extensive pain syndrome. Sternal pain is frequently accompanied by pain of the head, neck, back, and upper extremities. Further research on the possible etiology is warranted.
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Nicoline J
NJ
van Leersum
Rutger L
RL
van Leersum
Harriette F
HF
Verwey
Robert J M
RJ
Klautz
D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D056346:Sternotomy / Q000009:adverse effects*; D011795:Surveys and Questionnaires