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The morbidity, time course and predictive factors for persistent post‐thoracotomy pain
Author(s) -
Gotoda Yumiko,
Kambara Noriko,
Sakai Toshiko,
Kishi Yoshihiko,
Kodama Ken,
Koyama Tetsuo
Publication year - 2001
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 - 10.1053/eujp.2001.0225
Subject(s) - medicine , thoracotomy , surgery , dysesthesia , anesthesia , hypoesthesia
After thoracotomy, patients often suffer from a persistent pain syndrome called post‐thoracotomy pain. To elucidate morbidity, time course, and predictive factors for this syndrome, we analyzed follow‐up data for 85 post‐thoracotomy patients. We used a four‐point scale to assess pain: none, slight, moderate and severe. Of 85 patients, 50 reported pain (39 slight, 11 moderate) one day after surgery. A year after surgery, the patients were polled using a simple questionnaire received by the mail. Sixty patients reported persistent pain (34 slight, 14 moderate, 12 severe) a month after surgery, and 35 patients reported persistent pain (33 slight, two moderate) around the 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 alleviation was seen in 48% (41/85) of patients during months 2–12. Stepwise regression analysis revealed that female gender and pain at postoperative day 1 were predictive for persistent pain both 1 month and 1 year after thoracotomy. Among 35 patients with persistent pain 1 year after surgery, 24 cases 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.