title: Comparing the prevalence of chronic pain after sternotomy in patients undergoing coronary artery bypass grafting using the internal mammary artery and other open heart surgeries.
abstract: BACKGROUND
  The prevalence of chronic postoperative pain after cardiac surgery has been reported from 17% to 56%.
  
  
  OBJECTIVE
  We aimed to compare the prevalence of postoperative pain between patients who had undergone CABG using the internal mammary artery (IMA) and those who had undergone other cardiac surgeries including CABG using the saphenous vein or cardiac valvular surgeries.
  
  
  METHODS
  In this cohort study, medical records of 188 patients were evaluated and divided into two equal groups (94 in each group); patients who had undergone CABG using the IMA (IMA group) and those who had undergone other cardiac surgeries using the saphenous vein or other cardiac valvular surgeries (non-IMA group). The patients' data were recorded in a self-structured questionnaire and then phone interviews were performed 3 months after the operations regarding the rate of postoperative pain. The severity of chronic pain was rated based on the numerical rating pain scale.
  
  
  RESULTS
  The two groups differed significantly regarding the prevalence of pain (P = 0.023). In the IMA group, 83 (88.3%) patients experienced pain lasting for more than three months compared to 71 (75.5%) patients in non-IMA group. The two groups differed significantly with respect to the severity of chronic pain after cardiac surgery via sternotomy (P = 0.001). The groups did not differ significantly regarding the effects of chronic pain on their sleep, referral to a physician, and drug consumption to alleviate their pain. The IMA group experienced more complications at work and during their occupational activity.
  
  
  CONCLUSIONS
  The rate and severity of chronic pain after cardiac surgery via sternotomy was higher in patients undergoing CABG with separation of IMA for revascularization.
authors.affiliation: Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Kamalipour
authors.affiliation: Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Vafaei
authors.affiliation: Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Asef
authors.initials: A
authors.lastname: Parviz Kazemi
authors.affiliation: Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Khademi
keywords: Cardiac Surgery; Chronic Pain; Internal Mammary Artery; Sternotomy