Abstract
Thoracotomy is considered one of the most painful surgical procedures. In the literature, the estimate of the incidence of chronic post-thoracotomy pain (CPTP) is 26–67%. Possible risk factors for CPTP include severe acute post-operative pain, the female gender, and a young age. Epidural analgesia started preoperatively seems to decrease the risk of developing CPTP. Little is known about the aetiology of CPTP which seems to be a combination of both nociceptive and neuropathic pain, with possible aetiologic factors including damage in the intercostal nerves. Central sensitization is associated. The management of CPTP does not differ from that of other forms of neuropathic pain.
Résumé
La thoracotomie est considérée comme l’une des interventions chirurgicales les plus douloureuses. L’incidence des douleurs chroniques postthoracotomies (DCPT) varie de 26 à 67 % selon les études. Les facteurs prédictifs incluent une douleur postopératoire sévère, le sexe féminin et les sujets jeunes. L’analgésie péridurale débutée en préopératoire pourrait diminuer l’incidence des douleurs postopératoires et des DCPT. Les mécanismes sont mixtes, à la fois nociceptifs et neuropathiques, impliquant une lésion des nerfs intercostaux. Une sensibilisation centrale est associée. Le traitement des DCPT est calqué sur celui des autres types de douleurs neuropathiques.
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Cornet, C., Krakowski, I. Les séquelles douloureuses des thoracotomies: mise au point. Oncologie 10, 551–553 (2008). https://doi.org/10.1007/s10269-008-0952-x
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DOI: https://doi.org/10.1007/s10269-008-0952-x