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Ann Thorac Surg 1993;56:1107-1109
© 1993 The Society of Thoracic Surgeons

Articles

Effect of internal mammary harvest on postoperative pain and pulmonary function

Amram J. Cohen, MDa,b, Paul Moore, MDa,b, Carolyn Jones, BAa,b, Thomas J. Miner, MDa,b, Wallace R. Carter, MDa,b, Robert P. Zurcher, MD*,a,b, Ray Lupkas, MDa,b, Fred H. Edwards, MDa,b

a Department of Surgery, Cardiovascular Diseases, and Anesthesia, Walter Reed Army Medical Center, Washington, DC, USA
b Department of Surgery, Uniformed Services of the Health Sciences, Bethesda, Maryland USA

Accepted for publication December 28, 1993.

* Address reprint requests to Dr Zurcher, Cardiothoracic Surgery, Walter Reed Army Medical Center, Washington, DC 20307-5001.

Forty-three patients undergoing median sternotomy were evaluated for postoperative pain and pulmonary function. Group 1 (n = 26) had harvest of the internal mammary artery (IMA) and group 2 (n = 17) did not. Postoperative pain and pulmonary function were evaluated on the fifth postoperative day. Both groups showed a decrease in forced expiratory volume in 1 second (group 1, 44%; group 2, 39%), but there was no significant difference in the loss between the two groups (p = 0.32). Using a numeric rating scale, there was significant increase in postoperative pain in group 1 (group 1, 6.35; group 2, 3.82; p = 0.0002). There is a suggestion that internal mammary artery harvesting itself worsens postoperative pulmonary function tests, and this may be related to a significant increase in postoperative pain.




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