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Remifentanil during cardiac surgery is associated with chronic thoracic pain 1 yr after sternotomy
British Journal of Anesthesia, 07/27/2012
Clinical Article
van Gulik L et al. – In this follow–up study in cardiac surgery patients, intraoperative remifentanil was predictive for chronic thoracic pain in a dose–dependent manner.
Methods- A follow–up study was performed in 120 patients who participated in a clinical trial on pain levels in the early postoperative period after cardiac surgery.
- The presence of chronic thoracic pain was evaluated by a questionnaire 1yr after surgery.
- Patients with and without chronic thoracic pain were compared.
- Associations were studied using multivariable logistic regression analysis.
- Questionnaires of 90 patients were analysed.
- Chronic thoracic pain was reported by 18 patients (20%).
- In the multivariable regression model, remifentanil during cardiac surgery, age below 69yr, and a body mass index above 28kgm–2 were independent predictors for chronic thoracic pain {odds ratios 8.9 [95% confidence interval (CI) 1.6–49.0], 7.0 (95% CI 1.6–31.7), 9.1 (95% CI 2.1–39.1), respectively}.
- No differences were observed in patient and perioperative characteristics between patients receiving remifentanil (58%, n=52) compared with patients not receiving remifentanil (42%, n=38).
- The association between remifentanil and chronic thoracic pain appeared dose–dependent, both for total dose and for dose corrected for kilogram lean body mass and duration of surgery (P–value for trend:<0.01 and <0.005, respectively).
