The morbidity, time course and predictive factors for persistent post-thoracotomy pain

Citation
Y. Gotoda et al., The morbidity, time course and predictive factors for persistent post-thoracotomy pain, EUR J P-LON, 5(1), 2001, pp. 89-96
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology
Journal title
EUROPEAN JOURNAL OF PAIN-LONDON
ISSN journal
1090-3801 → ACNP
Volume
5
Issue
1
Year of publication
2001
Pages
89 - 96
Database
ISI
SICI code
1090-3801(2001)5:1<89:TMTCAP>2.0.ZU;2-S
Abstract
After thoracotomy, patients often suffer from a persistent pain syndrome ca lled post-thoracotomy pain. To elucidate morbidity, time course, and predic tive factors for this syndrome, we analyzed follow-up data for 85 post-thor acotomy patients. We used a four-point scale to assess pain: none, slight, moderate and severe. Of 85 patients, 50 reported pain (39 slight, 11 modera te) one day after surgery. A year after surgery, the patients were polled u sing a simple questionnaire received by the mail. Sixty patients reported p ersistent pain (34 slight, 14 moderate, 12 severe) a month after surgery, a nd 35 patients reported persistent pain (33 slight, two moderate) around th e time of the poll (1 year after surgery). Although pain deterioration was observed in 40% (34/85) of patients during month 1 after surgery, pain alle viation was seen in 48% (41/85) of patients during months 2-12. Stepwise re gression analysis revealed that female gender and pain at postoperative day 1 were predictive for persistent pain both 1 month and 1 year after thorac otomy. Among 35 patients with persistent pain 1 year after surgery, 24 case s reported paresthesia-dysesthesia, and 14 cases reported hypoesthesia. The present data thus suggests that persistent pain is common and often severe 1 month after surgery but is alleviated after 1 year. Clinical time course and symptoms indicate that nerve impairment rather than simple nociceptive impact may be involved in this syndrome. (C) 2001 European Federation of C hapters of the International Association for the Study of Pain.