Affecting Factors for Chronic Pain After Sternotomy

Ankara Etlik City Hospital

Status: Enrolling

Conditions: Cardiac Surgery; Pain, Acute; Pain, Chronic; Sternotomy

Treatments: Procedure: Open cardiac surgery with sternotomy

Study type: Observational

Funder types: Other

Identifiers

NCT06534372

AEŞH-EK1-2024-0068

Details and patient eligibility

About

Chronic pain is common complication of surgery procedures. Rates of mortalits is getting lower in cardiac surgery. This situation has brought us to focus morbidity and long term life quality. Previous study show that chronic pain after cardiac surgery is experienced 11-40% patient. Multifactorial causes play a role in chronic pain etiology. The aim of our study is to determine the causes of chronic pain in patients who underwent sternotomy.

Full description

Pain can be classified as anatomical, etiological, duration, intensity, and pathophysiological.

Classification according to duration is made according to the duration that the person feels the pain. Here, the classification is basically divided into acute and chronic. Acute pain is usually associated with acute injury or trauma. Chronic pain is defined as pain that continues after the expected period for the tissues to heal. Chronic pain is pain that lasts for 3 months or longer. Various conditions, usually including psychological and ethnic conditions, can affect the type of pain.

More than 2 million people worldwide undergo open heart surgery. Although mortality rates have decreased significantly thanks to advances in anesthesia and surgery, chronic pain after open heart surgery is still a serious problem. The rate of chronic pain varies between 11-40% within 1 year after cardiac surgery. Since open heart surgery is a very common procedure, it affects many people. Therefore; It is important to understand the factors related to the development of chronic pain.

Many risk factors have been identified for chronic pain after coronary artery bypass surgery. These are; female gender, young age, preoperative anxiety, intraoperative opioid use, and intense pain in the first days of the postoperative period. Although there are various retrospective and prospective studies on this subject, these studies are still insufficient and need support in the literature.

In this study, investigators aim to reveal the factors that increase chronic pain after sternotomy, take precautions against these factors and reduce the development of chronic pain.

Chronic pain is a problem that has been increasing in our country as well as all over the world in recent years. Therefore, defining the factors related to pain is very important. In our study, investigators aim to reveal the factors that increase chronic pain after sternotomy. By determining these factors, it will be possible to prevent the development of chronic pain in patients, reduce costs and increase the quality of life of patients. This study does not pose any risk for the patients to be included.

Enrollment: 500 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Between the ages of 18-80
• BMI 18-35 kg/m2
• ASA (American Society of Anesthesiologists) Scoring I-II-III
• Elective open coronary artery bypass graft surgery
• Elective open heart valve surgery
• Patients who will undergo general anesthesia
• Patients who agree to participate in the study and sign a form

Exclusion criteria

• Patients under 18 and over 80 years of age
• Patients who do not want to participate in the study
• Patients with advanced organ failure (liver failure, renal failure)
• Patients with chronic pain or chronic opioid use
• Patients with alcohol, substance or drug addiction
• Patients planned for surgery with thoracotomy
• Patients with a history of previous sternotomy (redo)
• Patients with limited cooperation such as dementia, psychiatric disorders
• Pregnant and breastfeeding patients will be excluded from the study.
• Patients who cannot communicate in their native language will be excluded from the study