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Anesthesiology. 2017 May;126(5):938-951. doi: 10.1097/ALN.0000000000001576.

A Prospective Study of Chronic Pain after Thoracic Surgery.

Author information

1
From the Department of Anesthesia (E.O.B., T.J.B.), Department of Biostatistics (E.O.B.), Department of Cardiothoracic Surgery (K.R.P., J.K.), and Department of Pharmacology (T.J.B.), University of Iowa, Iowa City, Iowa; and Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey (A.S.).

Abstract

BACKGROUND:

The goal of this study was to detect the predictors of chronic pain at 6 months after thoracic surgery from a comprehensive evaluation of demographic, psychosocial, and surgical factors.

METHODS:

Thoracic surgery patients were enrolled 1 week before surgery and followed up 6 months postsurgery in this prospective, observational study. Comprehensive psychosocial measurements were assessed before surgery. The presence and severity of pain were assessed at 3 and 6 months after surgery. One hundred seven patients were assessed during the first 3 days after surgery, and 99 (30 thoracotomy and 69 video-assisted thoracoscopic surgery, thoracoscopy) patients completed the 6-month follow-up. Patients with versus without chronic pain related to thoracic surgery at 6 months were compared.

RESULTS:

Both incidence (P = 0.37) and severity (P = 0.97) of surgery-related chronic pain at 6 months were similar after thoracotomy (33%; 95% CI, 17 to 53%; 3.3 ± 2.1) and thoracoscopy (25%; 95% CI, 15 to 36%; 3.3 ± 1.7). Both frequentist and Bayesian multivariate models revealed that the severity of acute pain (numerical rating scale, 0 to 10) is the measure associated with chronic pain related to thoracic surgery. Psychosocial factors and quantitative sensory testing were not predictive.

CONCLUSIONS:

There was no difference in the incidence and severity of chronic pain at 6 months in patients undergoing thoracotomy versus thoracoscopy. Unlike other postsurgical pain conditions, none of the preoperative psychosocial measurements were associated with chronic pain after thoracic surgery.

PMID:
28248713
PMCID:
PMC5395336
DOI:
10.1097/ALN.0000000000001576
[Indexed for MEDLINE]
Free PMC Article

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