Key result
Coronary artery bypass grafting surgery was associated with a 23.6% incidence of chronic post-surgical pain at a mean of 6.8 years, with the highest rate at leg surgical sites.
Why the study?
Chronic post-surgical pain represents a significant issue following surgery, but its long-term incidence and impact have not been well described after cardiac surgery.
Observational (n=89)
Answers are grounded in this paper and cite their sources.
Nearly one-quarter of patients experience chronic post-surgical pain at a mean of 6.8 years after CABG, particularly at saphenous vein graft harvest sites, which significantly impacts activities of daily living.
Background Chronic post‐surgical pain (CPSP) represents a significant issue for many patients following surgery; however, the long‐term incidence and impact have not been well described following cardiac surgery. Our aim was to characterize CPSP at least 5 years following coronary artery bypass grafting (CABG) surgery. Methods This prospective observational study investigated a cohort of patients from a larger trial investigating cognitive outcomes following CABG surgery, with 89 of 148 eligible patients (60.1%) assessed for CPSP at a mean (standard deviation [SD]) of 6.8 [1.2] years. Questionnaires interrogated pain presence, intensity, location, neuropathic characteristics, Geriatric Depression Scale scores (GDS) and instrumental activities of daily living (IADL). Results CPSP was described in 21/89 (23.6%), with 10 rating it as moderate to severe. Six of the CPSP patients (29%) met criteria for neuropathic pain (6.7% overall). The highest rate of CPSP was associated with the leg surgical site (chest 12/89 [13.5%], arm 8/68 [11.8%] and leg (saphenous vein graft—SVG) 11/37 [29.7%]; χ2 = 6.523, p = 0.038). IADL scores were significantly lower for patients with CPSP (mean [SD]: 36.7 [1.6] vs. no CPSP 40.6 [0.6]; p = 0.006). Patients had GDS scores consistent with moderate depression (GDS >8) in 3/21 (14.3%) with CPSP, versus 3/68 (4.4%) non‐CPSP patients (χ2 = 3.20, p = 0.073). Conclusions This study identified a CPSP incidence of 23.6% at a mean of 6.8 years after CABG surgery, with the highest pain proportion at SVG harvest sites. CPSP was associated with neuropathic pain symptoms and had a significant impact on IADLs. This emphasizes the need for long‐term follow‐up of CABG patients. Significance This study highlights the impact of CPSP 7 years following cardiac surgery and highlights the effect of surgical site, neuropathic pain and the importance of including pain assessment and management in the long‐term follow‐up of cardiac surgical patients. Strategies to address and prevent chronic pain following cardiac surgery should be further explored.
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Charlton et al. (2023) conducted an observational in Post-coronary artery bypass grafting (CABG) surgery (n=89). Coronary artery bypass grafting (CABG) surgery was evaluated on Chronic post-surgical pain (CPSP) incidence. Coronary artery bypass grafting surgery was associated with a 23.6% incidence of chronic post-surgical pain at a mean of 6.8 years, with the highest rate at leg surgical sites.
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