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Eur J Pain. 2015 Nov;19(10):1428-36. doi: 10.1002/ejp.673. Epub 2015 Mar 12.

Effects of β2 agonists on post-thoracotomy pain incidence.

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Centre d'Evaluation et de Traitement de la Douleur, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
Département d'Anesthésie-Réanimation Chirurgicale, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
Département de Pathologies Thoraciques, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique, France.



Pre-clinical research has shown β2 -adrenoceptors to be essential for the antiallodynic action of antidepressant drugs in murine models of neuropathic pain and that sustained treatment with β2 -agonists has an antiallodynic action. Here, we clinically investigated whether chronic β2 -agonist treatments may influence the incidence of post-thoracotomy chronic pain, defined as pain that recurs or persists along a thoracotomy scar more than 2 months after surgery, either neuropathic or non-neuropathic.


We conducted an epidemiological study on patients operated by thoracotomy. Demographic data, medical history and treatments concomitant to the surgery were recorded at a follow-up visit. Information on perioperative treatments was collected from the anaesthesia records and confirmed by the patients. In patients with pain at the surgery level, post-thoracotomy chronic pain was assessed by clinical examination and numeric scale. Physical examination and DN4 questionnaire were used to discriminate neuropathic and non-neuropathic chronic pain at scar level.


One hundred and eighty-nine patients were included. Eighty-one patients reported persisting thoracic pain, with neuropathic characteristics in 58 of them (30% of the 189 patients). The most common chronic drugs during the perioperative period were inhaled β2 -agonists (28.6%). The chronic use of β2 -agonists was an independent predictor of thoracic neuropathic pain (but not of non-neuropathic pain) and was associated with a five-fold decrease in the relative incidence of neuropathic pain [OR = 0.19 (0.06-0.45)].


These data suggest a possible influence of chronic β2 -agonist treatments on neuropathic pain secondary to thoracotomy. This apparent preventive effect of β2 -agonist treatments should warrant controlled clinical trials.

[Indexed for MEDLINE]

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