J Anesth Perioper Med. 2018;5(6):316-324. https://doi.org/10.24015/ebcmed.japm.2018.0112

Pain Management in Cardiac Surgery

Zhuan Zhang1, Wenxi Tang2, Chengmei Shi3, and Jiapeng Huang4

From the 1Department of Anesthesiology, The First People’s Hospital of Yangzhou, Yangzhou University, Yangzhou, China; 2Department of Anesthesiology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China; 3Department of Anesthesiology, Peking University Third Hospital, Beijing, China; 4Department of Anesthesiology & Perioperative Medicine, University of Louisville, Department of Anesthesia, Jewish Hospital, Louisville, KY, USA.

Correspondence to Dr. Jiapeng Huang at jiapenghuang@yahoo.com.

EBCMED ID: ebcmed.japm.2018.0112 DOI: 10.24015/ebcmed.japm.2018.0112


Abstract

Aim of review
Acute or chronic pain may occur after cardiac surgeries. This overview describes the epidemiology, pathophysiology, preoperative interventions, surgical techniques, pain medications, regional anesthesia, and alternative measures to relieve pain after cardiac surgeries. This review also discusses post-sternotomy and post-thoracotomy chronic pain and their management.

Methods
The articles published in the past 2 decades in this area were reviewed.

Recent findings
Both acute and chronic pain after cardiac surgery is common and could cause significant morbidity. Opioid and non-opioid analgesics are usually used medications for pain control. Recently, neuraxial and paravertebral anesthesia have been studied in cardiac surgeries with success yet carry concerns of neuraxial hematoma due to heparin administration.

Summary
Acute pain after cardiac surgeries is common and could lead to chronic pain syndromes. Analgesics need to be administrated regularly for pain control after cardiac procedures. Regional anesthesia could be a valuable adjunct for effective pain control after cardiac surgery. (Funded by the Yangzhou Natural Science Foundation, and The Affiliated Hospital of Yangzhou University, both in China.)

Article Type
Review Article

Declaration of Interests
The authors declare no conflicts of interest.

Acknowledgements
This study was supported by grants from the Yangzhou Natural Science Foundation, China (YZ2017122), and Key Project of The Affiliated Hospital of Yangzhou University, China (YZYY2018-07).

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.