Pain pattern and left internal mammary artery grafting

Background. This study was designed to determine whether the pain pattern i n patients with an internal mammary artery (IMA) harvest differs from that in other cardiac operations and whether these patients present specific cha racteristics with clinical implications. Methods. One hundred patients with left IMA grafting (IMA group) were compa red prospectively with 100 patients who had a heart operation without IMA h arvest (non-IMA group). Pain assessment was performed on postoperative days (POD) 1, 2, 3, and 7, and included pain intensity (10-point scale) and pai n localization. Results. In the IMA group, pain intensity was higher on FOD 2 (4.2 +/- 2.4 versus 3.2 +/- 2.3, p < 0.01), and there were more patients without pain on POD 7 (32 versus 19, p = 0.03). In the IMA group, more patients had left b asal thoracic pain throughout the entire study period and had sternal pain on POD 7,whereas more patients in the non-IMA group complained about back p ain during the early postoperative period. Conclusions. The impact of IMA harvest on pain intensity is moderate, but t he pain localization pattern of each group exhibits specific features that could help to better target pain management. (Ann Thorac Surg 2000;70:2045- 9) (C) 2000 by The Society of Thoracic Surgeons.