Overview of Chronic Post-thoracotomy Pain: Etiology and Treatment
The first reference to chronic post-thoracotomy pain was in 1944 by United States Army surgeons who noted ‘chronic intercostal pain’ in men who had thoracotomy for chest trauma during the Second World War . Chronic post-thoracotomy pain is defined by the International Association for the Study of Pain as pain that recurs or persists along a thoracotomy incision at least 2 months following the surgical procedure . It is typically burning and dysesthetic in nature and has many features of neuropathic pain [3, 4]. Post-thoracotomy pain also may result, at least in part, from a non-neuropathic origin (myofascial pain) . Several studies have estimated the incidence of post-thoracotomy pain as ranging from 25–60 % which makes postthoracotomy pain the commonest complication of thoracotomy. Thoracotomy, along with limb amputation, is considered to be the procedure that elicits the highest risk of severe chronic postoperative pain . This chapter outlines the prevalence of this condition and then discusses the potential etiological factors and treatment strategies and possible future research.
KeywordsMyofascial Pain Intercostal Nerve Thoracic Epidural Analgesia Posterolateral Thoracotomy Potential Etiological Factor
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