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Effects of β 2 agonists on post‐thoracotomy pain incidence
Author(s) -
Salvat E.,
Schweitzer B.,
Massard G.,
Meyer N.,
Blay F.,
Muller A.,
Barrot M.
Publication year - 2015
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.673
Subject(s) - neuropathic pain , medicine , perioperative , chronic pain , anesthesia , thoracotomy , incidence (geometry) , agonist , surgery , physical therapy , receptor , physics , optics
Background Pre‐clinical research has shown β 2 ‐adrenoceptors to be essential for the antiallodynic action of antidepressant drugs in murine models of neuropathic pain and that sustained treatment with β 2 ‐agonists has an antiallodynic action. Here, we clinically investigated whether chronic β 2 ‐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. Methods 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. Results 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 β 2 ‐agonists (28.6%). The chronic use of β 2 ‐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)]. Conclusions These data suggest a possible influence of chronic β 2 ‐agonist treatments on neuropathic pain secondary to thoracotomy. This apparent preventive effect of β 2 ‐agonist treatments should warrant controlled clinical trials.