Chronic pain is a common complication after cardiothoracic surgery. The prevalence of post-sternoyomy pain syndrome (PSPS) ranges from 33% to 91%. Exact pathogenetic mechanisms for developing chronic pain after sternotomy are unknown. Apart from intraoperative nerve damage and subsequent postoperative neuropathic pain, operation techniques, age, sex, pre-existing pain, genetic and psychosocial factors, severe postoperative pain, and analgesic management are suspected to have an impact on the development of PSPS .
age between 18 and 75 years.
patient scheduled to undergo elective on-pump cardiac surgery with sternotomy.
American Society of Anesthesiologists classification of physical status < IV.
emergency surgery.
off-pump surgery.
redo surgery.
ejection fraction less than 35%.