Age-related change of postoperative pain location after Nuss procedure for pectus excavatum

Tomohisa Nagasao, Junpei Miyamoto, Kazuhiko Ichihara, Hua Jiang, Hong Mei Jin, Tamotsu Tamaki

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Objective: The present study aims to evaluate age-related change of postoperative pain after the Nuss procedure by referring to clinical cases, and to elucidate the biomechanical aetiology of the change by using the finite element method. Methods: Twelve paediatric patients (paediatric group: 9.4 ± 2.3 years old) and 13 adult patients (adult group: 26.3 ± 5.5 years old) who received the Nuss procedure for pectus excavatum were included in the study. On the second postoperative day, the patients were asked to indicate regions on the thorax where they felt the greatest pain. The locations of these regions were compared between the two groups. In addition, stress-distribution patterns were examined using finite element models produced by simulating the thoraces of the patients. The stress-distribution patterns were compared between the two groups. Results: The patients of the paediatric group and adult group tend to have pain on the anterior and posterior regions of the thorax, respectively. The finite element study revealed that paediatric thoraces and adult thoraces develop intensified stresses in the anterior region and the posterior region, respectively. Conclusion: Postoperative pain tends to occur in the anterior part of the thorax for paediatric patients and in the posterior part of the thorax for adult patients, reflecting the stress distributions of these two distinct patient populations.

Original languageEnglish
Pages (from-to)203-208
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number2
Publication statusPublished - 2010 Aug
Externally publishedYes


  • Finite element analysis
  • Pain
  • Pectus excavatum
  • Stress
  • Thorax

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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