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U-shaped association between elapsed time after surgery and the intensity of chronic postsurgical pain following cardiac surgery via thoracotomy: an observational cohort study

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Abstract

Background

Chronic postsurgical pain (CPSP) is defined as chronic pain that develops or increases in intensity after a surgical procedure and persists beyond the healing process, defined as at least 3 months postoperatively. However, the rationale behind this time period is weak.

Methods

This prospective observational study included a total of 238 consecutive patients who underwent mitral valve repair via thoracotomy. A questionnaire consisting of a numerical rating scale (NRS) to assess the severity of postsurgical pain was mailed to each participant more than 3 months after the operation. The outcomes of interest were current pain, peak pain in the last 4 weeks, and average pain in the last 4 weeks, each assessed using the NRS. The nonlinear associations between the elapsed time after surgery and the intensity of CPSP were evaluated. All statistical analyses were performed with a two-sided significance level of 5%.

Results

Two-hundred and ten patients (88.2%) answered the questionnaire. There was a significant nonlinear association between the elapsed time after surgery and each NRS response (all, P < 0.05). The lowest adjusted log odds of current pain, peak pain in the past 4 weeks, and average pain in the past 4 weeks were − 1.49, − 1.13, and − 1.26 at 33, 33, and 33 months postoperatively, respectively.

Conclusions

There was a significant U-shaped association between the elapsed time after surgery and intensity of CPSP. The adjusted log odds of each NRS response was lowest at 33 months after cardiac surgery via thoracotomy.

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Funding

The authors have no sources of funding to declare for this manuscript.

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Authors and Affiliations

  1. Department of Surgical Intensive Care, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Kimito Minami & Masahiro Kazawa

  2. Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Takashi Kakuta, Satsuki Fukushima & Tomoyuki Fujita

  3. Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Yoshihiko Ohnishi

Authors
  1. Kimito Minami
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  2. Masahiro Kazawa
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  3. Takashi Kakuta
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  4. Satsuki Fukushima
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  5. Tomoyuki Fujita
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  6. Yoshihiko Ohnishi
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Contributions

KM: This author helped conduct and design the study, collected and analyzed the data, prepared the manuscript, approved the final manuscript, and attested to the integrity of the original data and the analysis reported in this manuscript. MK: This author collected and analyzed the data, approved the final manuscript and attested to the integrity of the original data and the analysis reported in this manuscript. TK: This author collected the data, approved the final manuscript and attested to the integrity of the original data and the analysis reported in this manuscript. SF: This author approved the final manuscript and attested to the integrity of the original data and the analysis reported in this manuscript. TF: This author approved the final manuscript and attested to the integrity of the original data and the analysis reported in this manuscript. YO: This author approved the final manuscript and attested to the integrity of the original data and the analysis reported in this manuscript.

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Correspondence to Kimito Minami.

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Minami, K., Kazawa, M., Kakuta, T. et al. U-shaped association between elapsed time after surgery and the intensity of chronic postsurgical pain following cardiac surgery via thoracotomy: an observational cohort study. Gen Thorac Cardiovasc Surg 70, 931–938 (2022). https://doi.org/10.1007/s11748-022-01825-3

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  • DOI: https://doi.org/10.1007/s11748-022-01825-3

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