TY  - CHAP
M1  - Book, Section
TI  - Postoperative Analgesia for Cardiac Surgery
A1  - Wasnick, John D.
A1  - Nicoara, Alina
PY  - 2019
T2  - Cardiac Anesthesia and Transesophageal Echocardiography, 2e
AB  - Cardiac  surgery  is  associated  with  significant  postoperative  pain.  Common  sources  include  surgical  incision  pain,  pain  associated  with  rib  retraction,  and  pain  from  chest  tubes  and  other  perioperative  appliances.  Other  potential  causes  include  incomplete  revascularization  of  the  myocardium,  sternal  wires,  epicardial  pacing  leads,  and  sternocostal  and  costovertebral  pain  from  retraction.1The  surgical  approach  has  an  obvious  impact  on  the  severity  of  postoperative  pain.  For  example,  minimally  invasive  cardiac  procedures  may  produce  less  overall  tissue  injury  and  result  in  less  postoperative  pain.  Postoperative  pain  for  midline  sternotomy  has  often  been  described  to  be  moderate,  and  patients’  anticipated  pain  level  tends  to  be  much  greater  than  the  actual  pain  they  experience  postoperatively.2  On  the  other  hand,  thoracotomy  has  been  associated  with  a  greater  degree  of  both  pain  and  functional  limitation,  due  to  the  pain  associated  with  breathing  and  coughing.3  Endoscopic  vein  graft  harvesting  has  decreased  the  severity  of  postoperative  leg  pain,  as  well  as  the  infection  and  wound  dehiscence  rate.4Patient  risk  factors  also  play  a  role  in  the  incidence  and  severity  of  postcardiac  surgical  pain,  with  younger  patients  (<  60  years  old)  and  those  with  a  higher  New  York  Heart  Association  (NYHA)  class  incurring  higher  pain  scores.5,6  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1166981642
ER  -