POST CABG SURGERY PAIN WITH THE USE OF SKELETONIZED VERSUS PEDICLED TECHNIQUE OF INTERNAL THORACIC ARTERY HARVESTING

Abstract

Objective: To document post coronary artery bypass graft (CABG) surgery painwith the use of skeletonized technique versus pedicled technique of internalthoracic artery (ITA) harvesting in our population.

Methodology: A cross sectional study was done from February 2014 toSeptember 2017. Patients who underwent elective on-pump coronary arterybypass graft surgery were included in the study. Patients ware subjected to twodifferent techniques for CABG surgery. Postoperatively CABG surgery painintensity was scored prior to discharge and at 01 month follow-up on a visualanalogue scale (VAS) ranging from 0 to 10. Chi square statistical test was utilized(p<0.05).

Results: Total of 197 patients ware included. In ninety nine patients the pedicledtechnique of left ITA conduit harvesting was utilized while in ninety eight patientsskeletonized left ITA was harvested. The Visual Analogue Score pre-discharge(VAS 0-10) was 2.61±0.23 in the skeletonized left ITA group and 2.58±0.31 inthe pedicled left ITA group. The Visual Analogue Score at 01 month afterdischarge (VAS 0-10) was 0.57±0.14 in the skeletonized left ITA group and1.21±0.18 in the pedicled left ITA group. The difference in the pre-discharge VASscores between the skeletonized and pedicled left ITA groups was not significantstatistically (p>0.05), whereas the Visual Analogue Score was significantlylower in the skeletonized left ITA group (p≤0.05) at one month follow up.

Conclusion: There is decreased post CABG surgery pain with the use ofskeletonized technique of internal thoracic artery harvesting compared topedicled technique.