Advertisement

Journal of Anesthesia

, Volume 33, Issue 1, pp 75–79 | Cite as

Postoperative thoracic and low back pain following endovascular aortic repair associated with stenting location

  • Hirotsugu MiyoshiEmail author
  • Hiroshi Hamada
  • Ryuji Nakamura
  • Takashi Kondo
  • Toshimichi Yasuda
  • Noboru Saeki
  • Masashi Kawamoto
Original Article

Abstract

Background

We have noted that patients frequently complain of thoracic or low back pain after undergoing an endovascular aortic repair, which we speculated was caused by the indwelling stent.

Methods

We investigated the patients who underwent an elective thoracic or abdominal endovascular aortic repair (TEVAR or EVAR) and noted the location of stent, and postoperative pain. The incidence of either thoracic or low back pain at individual vertebra levels was determined, after which we fitted the sigmoidal function to the discrete data to obtain a cut-off line. The study patients were then divided into 2 groups using the cut-off line to compare the incidence of pain.

Results

We analyzed 96 patients (68 TEVAR, 28 EVAR). The incidence of thoracic pain was significantly higher in TEVAR as compared to EVAR (26.5% vs. 3.6%, P = 0.01), while that of low back pain was significantly higher in EVAR (35.7% vs. 16.2%, P = 0.04). With the cut-off line for thoracic pain set at the 12th thoracic vertebra, the incidence of thoracic pain was significantly higher in patients with the upper end of the stent above the cut-off as compared to at a lower point (26.5% vs. 3.6%, P = 0.01). As for low back pain, the cut-off line was set at the 9th thoracic vertebra, and the incidence of that pain was significantly higher in patients with the lower end of the stent below that line (30.9% vs. 0.0%, P < 0.01).

Conclusion

Thoracic and low back pain after an endovascular aortic repair procedure were associated with stenting site.

Keywords

Endovascular aortic repair Postoperative pain Thoracic pain Low back pain 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Morishita K, Kurimoto Y, Kawaharada N, Fukada J, Hachiro Y, Fujisawa Y, Abe T. Descending thoracic aortic rupture: role of endovascular stent-grafting. Ann Thorac Surg. 2004;78:1630–4.CrossRefGoogle Scholar
  2. 2.
    Conti A, Paladini B, Toccafondi S, Magazzini S, Olivotto I, Galassi F, Pieroni C, Santoro G, Antoniucci D, Berni G. Effectiveness of a multidisciplinary chest pain unit for the assessment of coronary syndromes and risk stratification in the Florence area. Am Heart J. 2002;144:630–5.CrossRefGoogle Scholar
  3. 3.
    Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, Evangelista A, Fattori R, Suzuki T, Oh JK, Moore AG, Malouf JF, Pape LA, Gaca C, Sechtem U, Lenferink S, Deutsch HJ, Diedrichs H, Marcos y Robles J, Llovet A, Gilon D, Das SK, Armstrong WF, Deeb GM, Eagle KA. The International registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903.CrossRefGoogle Scholar
  4. 4.
    von Kodolitsch Y, Schwartz AG, Nienaber CA. Clinical prediction of acute aortic dissection. Arch Intern Med. 2000;160:2977–82.CrossRefGoogle Scholar
  5. 5.
    Clarke AM, Stillwell S, Paterson ME, Getty CJ. Role of the surgical position in the development of postoperative low back pain. J Spinal Disord. 1993;6:238–41.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Anesthesiologists 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical CareHiroshima University HospitalHiroshimaJapan
  2. 2.Department of Anesthesiology and Critical Care InstitutionHiroshima University HospitalHiroshimaJapan

Personalised recommendations