Ersoy Güler Gülsen
Department of Cardiovascular Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey.
J Pain Res. 2025 Jul 12;18:3543-3550. doi: 10.2147/JPR.S533349. eCollection 2025.
After coronary artery bypass graft surgery (CABG), patients may experience pain and numbness in the anterior chest wall. These symptoms can negatively impact patients' quality of life and overall cardiac surgery satisfaction. This study investigates the effect of monopolar electrocautery output power, for hemostasis in the remaining internal thoracic wall after harvesting of the Internal Thoracic Artery (ITA), on postoperative pain in the anterior chest wall.
This paper examined 100 patients who had ITA harvesting during CABG in a Cardiovascular Surgery Clinic. Patients who were able to comply with postoperative pain tests and had sufficient mental and visual capacity were included in the study. In Group 1 (n: 50) patient, after the ITA was harvested, hemostasis was performed with 20 watt cautery power on the inner wall of the thorax. In Group 2 (n: 50) patients, hemostasis was performed with 40 watt electrocautery power. It was investigated whether there was a difference between these two groups in terms of postoperative drainage amounts and pain in the anterior chest wall with Behavioral Pain Scale (BPS) and Visual Analogue Scale (VAS).
No statistically significant difference between Group 1 and Group 2 regarding demographic data and postoperative drainage amounts. However, in Group 1, in patients who hemostasis performed in the inner wall of the thorax with a low cautery power of 20 watts, postoperative pain was statistically significantly lower than in Group 2 in terms of BPS and VAS.
After harvesting of the ITA, hemostasis of the thoracic wall with 20 watt low cautery power does not affect the postoperative drainage. Additionally, these patients experience less postoperative pain due to less thermal damage after CABG. Furthermore, lower postoperative pain levels may reduce treatment costs by reducing analgesic requirements and intensive care duration.
冠状动脉旁路移植术（CABG）后，患者可能会出现前胸壁疼痛和麻木。这些症状会对患者的生活质量和心脏手术总体满意度产生负面影响。本研究调查了在获取胸廓内动脉（ITA）后，用于胸廓内壁止血的单极电灼输出功率对前胸壁术后疼痛的影响。
本文研究了在一家心血管外科诊所接受CABG并进行ITA获取的100例患者。能够配合术后疼痛测试且有足够精神和视力的患者纳入研究。在第1组（n = 50）患者中，获取ITA后，用20瓦灼烙功率对胸廓内壁进行止血。在第2组（n = 50）患者中，用40瓦电灼功率进行止血。通过行为疼痛量表（BPS）和视觉模拟量表（VAS）调查这两组在术后引流量和前胸壁疼痛方面是否存在差异。
第1组和第2组在人口统计学数据和术后引流量方面无统计学显著差异。然而，在第1组中，用20瓦低灼烙功率对胸廓内壁进行止血的患者，在BPS和VAS方面，术后疼痛在统计学上显著低于第2组。
获取ITA后，用20瓦低灼烙功率对胸壁进行止血不影响术后引流。此外，这些患者在CABG后因热损伤较小而术后疼痛较轻。此外，较低的术后疼痛水平可能通过减少镇痛需求和重症监护时间来降低治疗成本。
