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Persistent postsurgical pain after video‐assisted thoracic surgery – an observational study
Author(s) -
Wildgaard K.,
Ringsted T. K.,
Hansen H. J.,
Petersen R. H.,
Kehlet H.
Publication year - 2016
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12681
Subject(s) - medicine , observational study , thoracotomy , incidence (geometry) , anesthesia , prospective cohort study , visual analogue scale , postoperative pain , cardiothoracic surgery , surgery , physical therapy , physics , optics
Background The risk of persistent postsurgical pain ( PPP ) and subsequent pain‐related functional impairment may potentially be reduced by video‐assisted thoracic surgery ( VATS ) compared to thoracotomy. The aim of the study was therefore to assess in detail the incidence and consequences on activities of daily living of PPP after VATS . Methods Using a prospective observational design, 47 patients undergoing VATS completed both preoperative, early postoperative and 3 months follow‐up. Preoperative pain, pain characteristics, psychological factors, pain‐related functional impairment and quantitative sensory testing ( QST ) including nociceptive thresholds were compared with postoperative data. Results Only five (11%) patients developed PPP with NRS > 3 originating from the surgical area. However, about 30% of patients still reported some pain‐related functional impairment from the surgical area within four well‐defined domains of everyday activities. Psychological and sensory thermal tests did not predict persistent postoperative pain, except preoperative pin‐prick sensitivity was higher in patients with PPP . Postoperative pain 7 days after surgery was significantly higher in PPP patients. Preoperative pain originating from remote areas did not predict PPP . Conclusion The incidence of PPP , nerve damage (based on QST ) and pain‐related functional impairment following VATS was lower than reported following thoracotomy. No psychological or other factors predicted PPP . These findings call for further large‐scale studies to support VATS to decrease PPP .