Pain after sternotomy - review

Abstract

Background and objective: Adequate analgesia after sternotomy reduces postoperative adverse events. There are various methods of treating pain after heart surgery, such as infiltration with a local anesthetic, nerve block, opioids, non-steroidal anti-inflammatory drugs, alpha-adrenergic agents, intrathecal and epidural techniques, and multimodal analgesia.

Content: A review of the epidemiology, pathophysiology, prevention and treatment of pain after sternotomy. We also discuss the various analgesic therapeutic modalities, emphasizing advantages and disadvantages of each technique.

Conclusions: Heart surgery is performed mainly via medium sternotomy, which results in significant postoperative pain and a non-negligible incidence of chronic pain. Effective pain control improves patient satisfaction and clinical outcomes. There is no clearly superior technique. It is believed that a combined multimodal analgesic regimen (using different techniques) is the best approach for treating postoperative pain, maximizing analgesia and reducing side effects.

Keywords: Analgesia pós-operatória; Dor; Esternotomia; Pain; Postoperative analgesia; Sternotomy.

Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.