Asad Khan, Riffat Tanveer, Amina Nasreen.
Post CABG surgery pain with the use of skeletonized versus pedicled technique of internal thoracic artery harvesting.
Pak Heart J Jan ;52(3):245-9.

Objective: To document post coronary artery bypass graft (CABG) surgery pain with the use of skeletonized technique versus pedicled technique of internal thoracic artery (ITA) harvesting in our population. Methodology: A cross sectional study was done from February 2014 to September 2017. Patients who underwent elective on-pump coronary artery bypass graft surgery were included in the study. Patients ware subjected to two different techniques for CABG surgery. Postoperatively CABG surgery pain intensity was scored prior to discharge and at 01 month follow-up on a visual analogue 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 pedicled technique of left ITA conduit harvesting was utilized while in ninety eight patients skeletonized 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 in the pedicled left ITA group. The Visual Analogue Score at 01 month after discharge (VAS 0-10) was 0.57 +- 0.14 in the skeletonized left ITA group and 1.21 +- 0.18 in the pedicled left ITA group. The difference in the pre-discharge VAS scores between the skeletonized and pedicled left ITA groups was not significant statistically (p>0.05), whereas the Visual Analogue Score was significantly lower 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 of skeletonized technique of internal thoracic artery harvesting compared to pedicled technique.

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