title: Acute Pain and Analgesic Requirements After Pulmonary Endarterectomy With Deep Hypothermic Circulatory Arrest.
abstract: OBJECTIVE
  To assess postoperative pain intensity and the analgesic requirements in the postoperative period in patients undergoing sternotomy for pulmonary endarterectomy involving deep hypothermic circulatory arrest.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Single-center hospital study.
  
  
  METHODS
  Patients 18 years and older undergoing sternotomy for cardiac surgery between August 2012 and August 2014.
  
  
  METHODS
  No modification to usual clinical practice.
  
  
  RESULTS
  Intraoperative opioid and steroid administration, referral to the chronic pain unit, intensive care unit pain scores, and analgesic administration in the first 48 hours after the admission to the intensive care unit were recorded. Postoperative pain was evaluated by means of a categoric verbal scale from no pain (0) to severe pain (3); this is the routine analgesic scale used in the authors' intensive care unit. A total of 200 consecutive patients undergoing pulmonary endarterectomy (PEA group) were included in the study. No patient in the PEA group received morphine during surgery. The mean (standard deviation) postoperative pain intensity score at 24 hours was 0.30 (0.54) in the PEA group. Postoperative morphine was administered in 39% of patients. No PEA patient was referred to the chronic pain unit after hospital discharge.
  
  
  CONCLUSIONS
  The total analgesic requirements and pain score of patients undergoing sternotomy for pulmonary endarterectomy with deep hypothermic circulatory arrest seemed to be low.
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;. Electronic address: marc.gimenez@nhs.net.
authors.forename: Marc
authors.initials: M
authors.lastname: Giménez-Milà
authors.affiliation: Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Videla
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Jenkins
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Klein
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;
authors.forename: Caroline
authors.initials: C
authors.lastname: Gerrard
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;
authors.forename: Jacinta
authors.initials: J
authors.lastname: Nalpon
authors.affiliation: Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, United Kingdom;
authors.forename: Kamen
authors.initials: K
authors.lastname: Valchanov
mesh_terms: D059787:Acute Pain / Q000188:drug therapy*; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D050792:Circulatory Arrest, Deep Hypothermia Induced; D015331:Cohort Studies; D004691:Endarterectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy*; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
keywords: acute pain; analgesia; deep hypothermic circulatory arrest; pulmonary endarterectomy