Can chronic poststernotomy pain after cardiac valve replacement be reduced using thoracic epidural analgesia?

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Can chronic poststernotomy pain after cardiac valve replacement be reduced using thoracic epidural analgesia?

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Jensen MK; Andersen C Department of Cardiothoracic Anaesthesia, Odense University Hospital, Odense C, Denmark. kjaerscherer@dadlnet.dk BACKGROUND: The aim of our study was to evaluate the use of thoracic epidural analgesia (TEA) in acute pain management after cardiac valve replacement and determine if the incidence of chronic pain related to the sternotomy was reduced by the use of TEA. This patient group was chosen to exclude pain related to the use of the internal mammary artery and angina pectoris. METHODS: Patients scheduled for elective cardiac valve replacement were offered TEA. A match-control group was selected. Epidural catheter placement, complications and postoperative neurological state were noted for both groups. Eighteen months postoperatively, a questionnaire was sent out concerning pain management, wound discomfort and pain. RESULTS: Forty-nine patients were included. The TEA group consisted of 35 patients. At 18 months’ follow up, 37% from the TEA group and 21% from th