• Kimito Minami, Daijiro Kabata, Takashi Kakuta, Satsuki Fukushima, Tomoyuki Fujita, Kenji Yoshitani, and Yoshihiko Ohnishi.
• Department of Surgical Intensive Care, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: k.minami@ncvc.go.jp.
• J. Cardiothorac. Vasc. Anesth. 2021 Oct 1; 35 (10): 2937-2944.

ObjectiveInvestigate differences in the prevalence and severity of chronic postsurgical pain (CPSP) after cardiac surgery via thoracotomy versus sternotomy are not well-understood.DesignAn observational cohort study.SettingA tertiary care hospital.ParticipantsFour hundred twenty-eight patients (sternotomy: 192 patients, thoracotomy: 236 patients) who underwent mitral valve repair.InterventionsA questionnaire about the severity of surgical wound pain evaluated with a numerical rating scale (NRS) was sent. NRS responses for current pain, peak pain in the last four weeks, and average pain in the last four weeks were evaluated.Measurements And Main ResultsThe main outcomes were the severity of CPSP evaluated using NRS and the prevalence of CPSP. CPSP was defined as pain >0 that developed after a surgical procedure. During the median follow-up of 29 months, 79 patients complained of CPSP. (sternotomy: 15 patients, thoracotomy: 64 patients). Multivariate ordinal logistic regression showed that NRS responses for current pain (adjusted odds ratio [aOR], 3.17; 95% confidence interval [CI] 1.64-6.12; p = 0.001), peak pain in the last four weeks (aOR, 2.00; 95% CI 1.11-3.61; p = 0.021), and average pain in the last four weeks (aOR, 2.21; 95% CI 1.31-3.72; p = 0.003) were significantly higher in patients who underwent thoracotomy. Multivariate logistic regression showed that thoracotomy was an independent predictor of CPSP (aOR, 3.63; 95% CI 1.67-7.88; p = 0.001).ConclusionsThe prevalence and severity of CPSP were higher among patients who underwent mitral valve repair via thoracotomy than sternotomy.Copyright © 2021 Elsevier Inc. All rights reserved.

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