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Cardiothoracic Surgery |

Comparison of Sternal Pain and Narcotic Requirement After Cardiac Surgery Between New Rigid Closure and Conventional Wire Closure: Follow-up Results of 50 Randomizations

Jeevan Kumar, BS; Shinya Unai, MD; James Diehl, MD; Hitoshi Hirose, MD
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Thomas Jefferson University, Philadelphia, PA


Chest. 2013;144(4_MeetingAbstracts):114A. doi:10.1378/chest.1675356
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Abstract

SESSION TITLE: Cardiac and Thoracic Surgery Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

INTRODUCTION: Sternal stability by rigid sternal fixation could be better than conventional sternal wire. We performed a prospective randomized study to investigate if rigid closure reduces postoperative sternal pain and narcotic usage.

CASE PRESENTATION: Patients undergoing coronary artery bypass graft ± valve surgery between July 2011 and January 2013 were prospectively randomized into conventional wire closure (group C) or rigid fixation using sternal plates (group R) after approval by local institutional review board. Pain scores were determined daily from postoperative day 1 until day 5 at 6 AM using a numeric rating scale (0 no pain and 10 worst possible pain). Narcotic pain medication requirement from day 1 to 5 was collected and converted into intravenous morphine equivalent.

DISCUSSION: Among the total of 50 patients, 24 patients were in group R (20 male and 4 female, age 64.8 ± 8.8) and 26 patients were in group C (21 male and 5 female, age 65.1 ± 9.2). Preoperative risk factors and procedure were identical between the two groups. Pain scores were not significantly different between the two groups. Postoperative intubation time was 7.6 ± 5.0 hours in group R and 10.5 ± 10.5 hours in group C, p=0.21. Postoperative length of stay was 6.6± 2.9 days in group R and 7.1 ± 4.6 days in group C, p=0.65. Total narcotic given over 5 days was 90.3 mg ± 162.0 mg intravenous morphine equivalent in group R and 122.3 mg ± 318.9 mg intravenous morphine equivalent in group C (p=0.65).

CONCLUSIONS: Randomized data from this ongoing study showed no difference of pain score; however, a trend of less narcotic requirement which potentially facilitates earlier return to normal daily activity.

Reference #1: N/A

DISCLOSURE: The following authors have nothing to disclose: Jeevan Kumar, Shinya Unai, James Diehl, Hitoshi Hirose

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