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Pro: Regional Anesthesia for Cardiac Surgery with Sternotomy

  • Gabriel Rubio
    Correspondence
    Corresponding author: Gabriel Rubio, MD, Clinical Fellow, Division of Cardiovascular Anesthesiology at the Texas Heart Institute, Baylor St. Luke's Medical Center, Baylor College of Medicine., MC 1-226, PO Box 20345, Houston, TX 77225-0345 USA
    Affiliations
    Division of Cardiovascular Anesthesiology at the Texas Heart Institute, Baylor St. Luke's Medical Center, Baylor College of Medicine., MC 1-226, PO Box 20345, Houston, TX 77225-0345 USA
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  • Stephanie Opusunju Ibekwe
    Affiliations
    Division of Cardiovascular Anesthesiology at Ben Taub Hospital, Baylor College of Medicine., One Baylor Plaza, MS: BCM- 120, Houston, TX 77030, USA
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  • James Anton
    Affiliations
    Baylor College of Medicine Department of Anesthesiology, Chief, Division of Cardiovascular Anesthesiology and Critical Care Medicine, Texas Heart Institute, Baylor St. Luke's Medical Center., One Baylor Plaza, MS: BCM120, Houston, TX 77030-3411 USA
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  • Daniel Tolpin
    Affiliations
    Division of Cardiovascular Anesthesiology at the Texas Heart Institute, Baylor St. Luke's Medical Center, Baylor College of Medicine., MC 1-226, PO Box 20345, Houston, TX 77225-0345 USA
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Published:January 15, 2023DOI:https://doi.org/10.1053/j.jvca.2023.01.012
      With the growing prevalence of cardiovascular disease worldwide, over 2 million patients undergo median sternotomy for cardiac surgery annually.1 The incidence of severe acute postoperative pain after sternotomy is as high as 49%, and appropriate management of this pain has important implications for short- and long-term recovery.2 Inadequate post-surgical pain control following sternotomy in cardiac surgery has profound negative consequences on pulmonary function, hemodynamics, myocardial oxygen demand, postoperative delirium, and ICU and hospital length of stay.3 Severe pain has also been shown to harm long-term outcomes such as quality of life4,5 and is associated with the development of persistent post-sternotomy pain with an incidence as high as 35% at 1-year follow-up.1,6

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