CHARACTERISTICS AND PREDICTORS OF CHRONIC NON-ANGINAL POSTOPERATIVE PAIN AFTER OPEN-HEART SURGERY IN A COHORT OF PAKISTANI POPULATION

Abstract

Objective: This study aimed to assess the location and intensity of chronic nonanginalpost-operative pain (CPOP) after heart surgery and identify the predictingfactors.

Methodology: This cross sectional study was conducted from August 2010 toJuly 2011 at Armed Forces Institute of Cardiology, Rawalpindi. The CPOP wasdefined as pain in chest-wall, shoulder or neck of at least 3 months duration,appearing after heart surgery, excluding angina. The relationship of CPOP wasevaluated with age, gender, smoking, hypertension, diabetes mellitus (DM),hypercholesterolemia, chronic obstructive airway disease (COAD) and the typeof operation.

Results: The post operative patients recruited were 100. Mean age was 47 ± 6years. Majority were males (73.6%) and non-smokers (50.6%). Hypertensionwas found in 85.1%, DM in 44.8%, COAD in 16.1% and hypercholesterolemia in89.7%.The bulk (62.1%) underwent coronary artery bypass grafting. Postoperatively95.5% had pain in chest-wall, 89.7% in shoulders and 65.5 % in neck.Maximum (88.5%) subjects felt CPOP of moderate intensity. The shoulder painwas significantly more common in diabetics and neck pain in subjects withCOAD. The chest-wall pain was significantly common in individuals after valvereplacements. Age, gender, smoking, hypertension and hypercholesterolemiadid not have significant relationship with CPOP development.

Conclusion: CPOP in our sample was found located primarily in the chest-walland was moderate in intensity. Significant relationship existed between CPOP atshoulder and DM, CPOP in neck and COAD and CPOP in the chest-wall and thetype of operation.