Predictors and patterns of chronic pain three months after cardiac surgery in Taiwan.

OBJECTIVES Clinicians and researchers have a very limited understanding of how acute pain after cardiac surgery may develop into chronic pain. The aims of this study were to describe the pattern of pain during the first 3 months after cardiac surgery and to examine the predictors of surgery-related chronic pain. DESIGN A prospective panel study was conducted to monitor changes in worst and average pain intensity before and during the first 3 months following cardiac surgery in a sample of Taiwanese patients. Fifty-three patients who underwent a midsternotomy rated pain intensity before surgery and at postoperative days 7, 10, 30, and 90. The participants also rated beliefs about opioid use, and their medical records were reviewed to document opioid use during the first week after surgery. RESULTS The patients who reported chronic pain 90 days following surgery showed an unusual pattern of an increase in pain from 10 to 30 days after surgery. Higher worst pain intensity ratings at 30 days following surgery and more negative beliefs in opioid use were both associated with a greater likelihood of reporting chronic pain at 3 months. CONCLUSION Patients reporting a pattern of increasing pain starting about 10 days after surgery and holding negative beliefs about opioid use are at risk of developing chronic pain and may require more careful monitoring and pain treatment. The possible benefits of interventions that minimize pain during the weeks after surgery and that alter negative beliefs about opioid use should be examined in future research.