Pain Management in Cardiac Surgery

Zhuan Zhang , Wenxi Tang , Chengmei Shi , Jiapeng Huang
Department of Anesthesiology, The First People’s Hospital of Yangzhou, Yangzhou University, Yangzhou, China, Department of Anesthesiology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China, Department of Anesthesiology, Peking University Third Hospital, Beijing, China, Department of Anesthesiology & Perioperative Medicine, University of Louisville, Department of Anesthesia, Jewish Hospital, Louisville, KY, USA
J Anesth Perioper Med 2018; 5(6): 346- 354 . Published on Nov 28, 2018 . doi:10.24015/JAPM.2018.0112
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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.)  
Citation: Zhuan Zhang, Wenxi Tang, Chengmei Shi, Jiapeng Huang. Pain Management in Cardiac Surgery. J Anesth Perioper Med 2018;5:346-354. doi: 10.24015/JAPM.2018.0112
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