Audit of postoperative pain management after open thoracotomy and the incidence of chronic postthoracotomy pain in more than 500 patients at a tertiary center

J Clin Anesth. 2017 Feb:36:174-177. doi: 10.1016/j.jclinane.2016.10.011. Epub 2016 Dec 7.

Abstract

Study objective: To evaluate the quality of postoperative pain relief during the first 3 days after surgery and to evaluate with the incidence of persistent pain at 6 months after surgery.

Design: Retrospective single-center audit.

Setting: University hospital.

Patients: Five hundred four patients who underwent thoracotomy.

Interventions: Review of patient records, questionnaire, and telephone review.

Results: Of the 364 survivors, 306 were contacted. Five or more episodes of severe pain (numerical rating scale >6/10 at rest or movement) during the first 72 hours after surgery occurred in 133 patients. Persistent postsurgical pain at 6 months was present in 82% (109/133) of these patients. Patient satisfaction with acute postoperative pain management was excellent (36%), good (43%), and fair or poor (21%).The incidence of postthoracotomy pain was 56% (mild 32%, moderate 18%, and severe 6%).

Conclusions: Poorly controlled acute postoperative pain correlated with persistent postsurgical pain at 6 months. In view of such a high incidence in thoracotomy patients, preventative strategies assume great significance.

Keywords: Chronic postthoracotomy pain; Epidural analgesia; Postoperative pain management.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Analgesia, Epidural / methods
  • Analgesia, Epidural / standards
  • Analgesia, Patient-Controlled / methods
  • Analgesia, Patient-Controlled / standards
  • Chronic Pain / etiology*
  • Female
  • Humans
  • Male
  • Medical Audit / methods
  • Middle Aged
  • Pain Management / methods*
  • Pain Management / standards
  • Pain Measurement / methods
  • Pain, Postoperative / prevention & control*
  • Patient Satisfaction
  • Postoperative Care / methods
  • Postoperative Care / standards
  • Quality of Health Care
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers / standards
  • Thoracotomy / adverse effects*