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Pain Problems » Chest » Post-sternotomy Pain (Post Surgical Pain)

In these days, where open-heart surgery is done so commonly, poststernotomy syndromes are equal in incidence. This has been reported as having an overall incidence of 56%. The incidence seems to be higher in patients who have undergone internal mammary artery harvesting for graft reconstruction. Not all patients develop the post sternotomy chronic pain syndrome, but a large group of patients express their inability to perceive normal sensation following surgery.
The pain, which they develop, could be because of overzealous stretching of chest wall, hence injuring lower components of brachial plexus, incomplete union of sternum in view of less vascularity, adhesions between posterior surface of sternum and mediastinal structures etc.

This pain appears to be a kind of deafferentation (interrupted nerve supply) pain. Many people get adapted over course of time to pain. As a preventive aspect, cryodenervation of thoracic nerves during the surgery when chest is open appears to be promising. 

  1. Medical Management
  2. Interventions (only if necessary)
    - Scar infiltration
    - Trigger point injection