General Thoracic and Cardiovascular Surgery

, Volume 62, Issue 1, pp 58–63 | Cite as

Chest tube insertion is one important factor leading to intercostal nerve impairment in thoracic surgery

  • Takuro Miyazaki
  • Tetsuya Sakai
  • Naoya Yamasaki
  • Tomoshi Tsuchiya
  • Keitaro Matsumoto
  • Tsutomu Tagawa
  • Go Hatachi
  • Koichi Tomoshige
  • Mariko Mine
  • Takeshi Nagayasu
Original Article



Chest tube insertion seems to be one important factor leading to intercostal nerve impairment. The purpose of this prospective study was to objectively evaluate intercostal nerve damage using current perception threshold testing in association with chest tube insertion.


Sixteen patients were enrolled in this study. Intercostal nerve function was assessed with a series of 2000-Hz (Aβ fiber), 250-Hz (Aδ fiber), and 5-Hz (C fiber) stimuli using current perception threshold testing (Neurometer CPT/C®). Current perception threshold values at chest tube insertion were measured before surgery, during chest tube insertion and after removal of the chest tube. Intensities of ongoing pain were also assessed using a numeric rating scale (0–10).


Current perception thresholds at each frequency after surgery were significantly higher than before surgery. Numeric rating scale scores for pain were significantly reduced from 3.3 to 1.9 after removal of the chest tube (p = 0.004). The correlation between current perception threshold value at 2000 Hz and intensity of ongoing pain was marginally significant (p = 0.058).


This is the first study to objectively evaluate intercostal nerve damage at chest tube insertion. The results confirmed that chest tube insertion has clearly deleterious effects on intercostal nerve function.


Pain Lung cancer surgery Thoracotomy Thoracoscopy/VATS 


Conflict of interest

Miyazaki and other co-authors have no conflict of interest.


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Copyright information

© The Japanese Association for Thoracic Surgery 2013

Authors and Affiliations

  • Takuro Miyazaki
    • 1
  • Tetsuya Sakai
    • 2
  • Naoya Yamasaki
    • 1
  • Tomoshi Tsuchiya
    • 1
  • Keitaro Matsumoto
    • 1
  • Tsutomu Tagawa
    • 1
  • Go Hatachi
    • 1
  • Koichi Tomoshige
    • 1
  • Mariko Mine
    • 3
  • Takeshi Nagayasu
    • 1
  1. 1.Division of Surgical OncologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  2. 2.Division of AnesthesiologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  3. 3.Division of Scientific Data Registry, Atomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan

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