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Retraction Speed and Chronic Poststernotomy Pain: A Randomized Controlled Trial

Thursday, April 24, 2025

Submitted by

Jade Qu

Source

Source Name: The Journal of Thoracic and Cardiovascular Surgery

Source URL: https://www.jtcvs.org/article/S0022-5223(23)01113-3/abstract

Author(s)

Rachel Phelan, Dimitri Petsikas, Jessica Shelley, Wilma M. Hopman, Deborah DuMerton, Monica Parry, Darrin Payne, Rene Allard, Michael Cummings, Joel L. Parlow, Robert Tanzola, Louie T.S. Wang, Craig Stewart, Tarit K. Saha

This randomized controlled trial explored whether the speed of sternal retraction during cardiac surgery is associated with chronic poststernotomy pain (CPSP). While risk factors such as higher body mass index (BMI), female sex, and younger age are known to be linked to CPSP, no causal determinants have been established.

The study compared slower sternal retraction over 15 minutes to the standard retraction speed of 30 seconds. A total of 313 patients were randomized, with 159 assigned to the slow retraction group and 154 to the standard retraction group. Patients, assessors, and postoperative staff were blinded to the intervention. Pain levels, analgesic use, CPSP incidence, and complications were evaluated at three, six, and 12 months using the Medical Outcomes Survey Short Form.

Results revealed no significant differences in acute pain, CPSP incidence, analgesic consumption, or quality of life outcomes. These findings help rule out sternal retraction speed as a causal factor for CPSP.