Amjad Hussain, Saeed Bin Ayaz, Syed Naveed Mumtaz, Khalil Ahmad.
Characteristics and predictors of chronic non-anginal postoperative pain after open-heart surgery in a cohort of Pakistani population.
Pak Heart J Jan ;48(2):101-6.

Objective: This study aimed to assess the location and intensity of chronic non-anginal post-operative pain (CPOP) after heart surgery and identify the predicting factors. Methodology: This cross sectional study was conducted from August 2010 to July 2011 at Armed Forces Institute of Cardiology, Rawalpindi. The CPOP was defined as pain in chest-wall, shoulder or neck of at least 3 months duration,appearing after heart surgery, excluding angina. The relationship of CPOP was evaluated with age, gender, smoking, hypertension, diabetes mellitus (DM), hypercholesterolemia, chronic obstructive airway disease (COAD) and the type of operation. Results: The post operative patients recruited were 100. Mean age was 47 +- 6 years. Majority were males (73.6%) and non-smokers (50.6%). Hypertension was found in 85.1%, DM in 44.8%, COAD in 16.1% and hypercholesterolemia in 89.7%.The bulk (62.1%) underwent coronary artery bypass grafting. Post-operatively 95.5% 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 pain was significantly more common in diabetics and neck pain in subjects with COAD. The chest-wall pain was significantly common in individuals after valve replacements. Age, gender, smoking, hypertension and hypercholesterolemia did not have significant relationship with CPOP development. Conclusion: CPOP in our sample was found located primarily in the chest-wall and was moderate in intensity. Significant relationship existed between CPOP at shoulder and DM, CPOP in neck and COAD and CPOP in the chest-wall and the type of operation.

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