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Chronic Post-thoracotomy Pain

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Principles and Practice of Anesthesia for Thoracic Surgery

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Abstract

Chronic pain after surgery is surprisingly common. Chronic post-thoracotomy pain (CPTP) is a common sequela of chest surgery affecting as many as one half of patients. The pain of this condition may extend from the time of surgery or begin anew in the months after the procedure. Of those affected by CPTP more than one half will have neuropathic pain. CPTP has a significant impact on the daily lives of the patients. It impairs sleep and daily activity, and up to 40% of patients will continue to take an analgesic 2 years after the surgery. Less invasive surgical practices may reduce rates of CPTP although the rates CPTP after VATS are similar to those of traditional thoracotomy techniques. Less traumatic methods of opening and closing the chest have a significant impact on the rate of CPTP. Advances in novel treatments for neuroinflammation may someday play a role in control of pain after thoracotomy. Optimal prevention and treatment of CPTP may involve inter-professional and interdisciplinary management to identify risk factors, optimize surgical technique, and provide optimal anesthetic management, perioperative, and chronic pain interventions.

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References

  1. Crombie IK, Davies HT, Macrae WA. Cut and thrust: antecedent surgery and trauma among patients attending a chronic pain clinic. Pain. 1998;76(1–2):167.

    Article  CAS  PubMed  Google Scholar 

  2. Macrae WA. Chronic pain after surgery. Br J Anaesth. 2001;87(1):88.

    Article  CAS  PubMed  Google Scholar 

  3. Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth. 2008;101(1):77.

    Article  CAS  PubMed  Google Scholar 

  4. Burke S, Shorten G. When pain after surgery doesn’t go away …. Biochem Soc Trans. 2009;37(1):318.

    Article  CAS  PubMed  Google Scholar 

  5. Eisenberg E. Post-surgical neuralgia. Pain. 2004;111(1–2):3.

    Article  PubMed  Google Scholar 

  6. Kehlet H, Jensen T, Woolf C. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367(9522):1618.

    Article  PubMed  Google Scholar 

  7. Vilholm OJ, Cold S, Rasmussen L, Sindrup SH. Sensory function and pain in a population of patients treated for breast cancer. Acta Anaesthesiol Scand. 2009;53(6):800.

    Article  CAS  PubMed  Google Scholar 

  8. Poleshuck E, Katz J, Andrus C, Hogan L, Jung B, Kulick D, et al. Risk factors for chronic pain following breast cancer surgery: a prospective study. J Pain. 2006;7(9):626.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Steegers MA, Wolters B, Evers AW, Strobbe L, Wilder-Smith OH. Effect of axillary lymph node dissection on prevalence and intensity of chronic and phantom pain after breast cancer surgery. J Pain. 2008;9(9):813.

    Article  PubMed  Google Scholar 

  10. Amichetti M, Caffo O. Pain after quadrantectomy and radiotherapy for early-stage breast cancer: incidence, characteristics and influence on quality of life. Results from a retrospective study. Oncology. 2003;65(1):23.

    Article  PubMed  Google Scholar 

  11. Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002;1(3):182.

    Article  PubMed  Google Scholar 

  12. Nikolajsen L, Jensen TS. Phantom limb pain. Br J Anaesth. 2001;87(1):107.

    Article  CAS  PubMed  Google Scholar 

  13. Jensen TS, Krebs B, Nielsen J, Rasmussen P. Immediate and long-term phantom limb pain in amputees: incidence, clinical characteristics and relationship to pre-amputation limb pain. Pain. 1985;21(3):267.

    Article  CAS  PubMed  Google Scholar 

  14. Aasvang EK, Bay-Nielsen M, Kehlet H. Pain and functional impairment 6 years after inguinal herniorrhaphy. Hernia. 2006;10(4):316.

    Article  CAS  PubMed  Google Scholar 

  15. Aasvang E, Kehlet H. Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth. 2005;95(1):69.

    Article  CAS  PubMed  Google Scholar 

  16. Johansen A, Romundstat L, Nielsen CS, Schirmer H, Stubhaug A. Persistent postsurgical pain in a general population: prevalence and predictors in the Tromso study. Pain. 2012;153:1390–6.

    Article  PubMed  Google Scholar 

  17. Fletcher D, Stamer UM, Pogatzki-Zahn E, Zaslansky R, Tanase NV, Perruchoud C, et al. Chronic postsurgical pain in Europe. An observational study. Eur J Anasethesiol. 2015;32:725–34.

    Article  Google Scholar 

  18. Tang NKY, Crane C. Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychol Med. 2006;36(5):575.

    Article  PubMed  Google Scholar 

  19. Racine M, Sanchez-Rodriguez E, Galan S, Tome-Pires C, Sole E, Jensen MP, et al. Factors associated with suicidal ideation in patient with chronic non-cancer pain. Pain Med. 2017;18:283–93.

    PubMed  Google Scholar 

  20. Perttunen K, Tasmuth T, Kalso E. Chronic pain after thoracic surgery: a follow-up study. Acta Anaesthesiol Scand. 1999;43(5):563.

    Article  CAS  PubMed  Google Scholar 

  21. Dajczman E, Gordon A, Kreisman H, Wolkove N. Long-term postthoracotomy pain. Chest. 1991;99(2):270.

    Article  CAS  PubMed  Google Scholar 

  22. Hazelrigg S, Cetindag I, Fullerton J. Acute and chronic pain syndromes after thoracic surgery. Surg Clin North Am. 2002;82(4):849.

    Article  PubMed  Google Scholar 

  23. Kalso E, Perttunen K, Kaasinen S. Pain after thoracic surgery. Acta Anaesthesiol Scand. 1992;36(1):96.

    Article  CAS  PubMed  Google Scholar 

  24. Baron R. Neuropathic pain: a clinical perspective. Handb Exp Pharmacol. 2009;194:3.

    Article  CAS  Google Scholar 

  25. O’Connor A. Neuropathic pain: quality-of-life impact, costs and cost effectiveness of therapy. PharmacoEconomics. 2009;27(2):95.

    Article  PubMed  Google Scholar 

  26. Costigan M, Scholz J, Woolf C. Neuropathic pain: a maladaptive response of the nervous system to damage. Annu Rev Neurosci. 2009;32:1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Maguire MF, Ravenscroft A, Beggs D, Duffy JP. A questionnaire study investigating the prevalence of the neuropathic component of chronic pain after thoracic surgery. Eur J Cardiothorac Surg. 2006;29(5):800.

    Article  PubMed  Google Scholar 

  28. Steegers MAH, Snik DM, Verhagen AF, van der Drift MA, Wilder-Smith OHG. Only half of the chronic pain after thoracic surgery shows a neuropathic component. J Pain. 2008;9(10):955.

    Article  PubMed  Google Scholar 

  29. Hopkins KG, Hoffman LA, Dabbs ADV, Ferson PF, King L, Dudjak LA, et al. Postthoracotomy pain syndrome following surgery for lung cancer: symptoms and impact on quality of life. J Adv Pract Oncol. 2015;6:121–32.

    PubMed  PubMed Central  Google Scholar 

  30. Mongardon N, Pinton-Gonnet C, Szekely B, Michel-Cherqui M, Dreyfus J-F, Fischler M. Assessment of chronic pain after thoracotomy: a 1 year prevalence study. Clin J Pain. 2011;27:167–81.

    Article  Google Scholar 

  31. Katz J, Jackson M, Kavanagh BP, Sandler AN. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain. 1996;12(1):50.

    Article  CAS  PubMed  Google Scholar 

  32. Pluijms WA, Steegers MAH, Verhagen AFTM, Scheffer GJ, Wilder-Smith OHG. Chronic post-thoracotomy pain: a retrospective study. Acta Anaesthesiol Scand. 2006;50(7):804.

    Article  CAS  PubMed  Google Scholar 

  33. Katz J, Asmundson GJG, McRae K, Halket E. Emotional numbing and pain intensity predict the development of pain disability up to one year after lateral thoracotomy. Eur J Pain. 2009;13(8):870.

    Article  PubMed  Google Scholar 

  34. Hetmann F, Kongsgaard UE, Sandvik L, Schoou-Bredal I. Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6 and 12 month follow-ups. J Pain Res. 2017;10:663–8.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Hetmann F, Kongsgaard UE, Sandvik L, Schou-Bredal I. Prevalence and predictors of persistent post-surgical pain 12 months after thoracotomy. Acta Anaesthesiol Scand. 2015;59:740–8.

    Article  CAS  PubMed  Google Scholar 

  36. Shanthanna H, Aboutouk D, Poon E, Cheng J, Finley C, Paul J, Thabane L. A retrospective study of open thoracotomies versus thoracoscopic surgeries for persistent postthoracotomy pain. J Clin Anesth. 2016;35:215–20.

    Article  PubMed  Google Scholar 

  37. Ochroch EA, Gottschalk A, Augostides J, Carson K, Kent L, Malayaman N, et al. Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia. Anesthesiology. 2002;97(5):1234.

    Article  PubMed  Google Scholar 

  38. Ochroch EA, Gottschalk A, Augoustides J, Aukburg S, Kaiser L, Shrager J. Pain and physical function are similar following axillary, muscle-sparing vs posterolateral thoracotomy. Chest. 2005;128(4):2664.

    Article  PubMed  Google Scholar 

  39. Peng Z, Li H, Zhang C, Qian X, Feng Z, Zhu S. A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on quality of life. PLoS One. 2014;9:1–7.

    Google Scholar 

  40. Gotoda Y, Kambara N, Sakai T, Kishi Y, Kodama K, Koyama T. The morbidity, time course and predictive factors for persistent post-thoracotomy pain. Eur J Pain. 2001;5(1):89.

    Article  CAS  PubMed  Google Scholar 

  41. Gottschalk A, Ochroch EA. Clinical and demographic characteristics of patients with chronic pain after major thoracotomy. Clin J Pain. 2008;24(8):708.

    Article  PubMed  Google Scholar 

  42. Stewart W, Ricci J, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290:2443.

    Article  CAS  PubMed  Google Scholar 

  43. Jackson T, Thomas S, Stabile V, Shotwell M, Han X, McQueen K. A systematic review and meta-analysis of the global burden of chronic pain without clear etiology in low and middle-income countries: trends in heterogeneous data and a proposal for new assessment methods. Anesth Analg. 2016;123:739–48.

    Article  PubMed  Google Scholar 

  44. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life and treatment. Eur J Pain. 2006;10:287–333.

    Article  PubMed  Google Scholar 

  45. Ochroch EA, Gottschalk A, Troxel AB, Farrar JT. Women suffer more short and long-term pain than men after major thoracotomy. Clin J Pain. 2006;22(5):491.

    Article  PubMed  Google Scholar 

  46. Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982;72(8):800.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Kaplan GA, Goldberg DE, Everson SA, Cohen RD, Salonen R, Tuomilehto J, et al. Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. Int J Epidemiol. 1996;25(2):259.

    Article  CAS  PubMed  Google Scholar 

  48. Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21.

    Article  CAS  PubMed  Google Scholar 

  49. Liebeskind JC. Pain can kill. Pain. 1991;44(1):3.

    Article  CAS  PubMed  Google Scholar 

  50. Watkins LR, Maier SF. Immune regulation of central nervous system functions: from sickness responses to pathological pain. J Intern Med. 2005;257(2):139.

    Article  CAS  PubMed  Google Scholar 

  51. Li X, Hu L. The role of stress regulation on neuroplasticity in pain chronicfication. Neural Plast. 2016. https://doi.org/10.1155/2016/6402942.

    Google Scholar 

  52. Kinney MO, Hooten WM, Cassivi SD, Allen MS, Passe MA, Hanson AC, et al. Chronic post-thoracotomy pain and health-related quality of life. Ann Thorac Surg. 2012;93:1242–7.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Wildgaard K, Ravn J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg. 2009;36:170–80.

    Article  PubMed  Google Scholar 

  54. Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology. 2000;93(4):1123.

    Article  CAS  PubMed  Google Scholar 

  55. Brandsborg B, Nikolajsen L, Hansen C, Kehlet H, Jensen T. Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology. 2007;106(5):1003.

    Article  PubMed  Google Scholar 

  56. Brandsborg B, Dueholm M, Nikolajsen L, Kehlet H, Jensen T. A prospective study of risk factors for pain persisting 4 months after hysterectomy. Clin J Pain. 2009;25(4):263.

    Article  PubMed  Google Scholar 

  57. Gerbershagen HJ, Ozgur E, Dagtekin O, Straub K, Hahn M, Heidenreich A, et al. Postoperative pain as a risk factor for chronic post-surgical pain – six month follow-up after radical prostatectomy. Eur J Pain. 2009;13:1054–61.

    Article  PubMed  Google Scholar 

  58. Hoofwijk DMN, van Reij RRI, Rutten BP, Kenis G, Buhre WF, Joosten EA. Genetic polymorphisms and their association with the prevalence and severity of chronic postsurgical pain: a systematic review. BJA. 2016;117:708–19.

    Article  CAS  PubMed  Google Scholar 

  59. Niraj G, Kelkar A, Kaushik V, Tang Y, Fleet D, Tait F, et al. Audit of postoperative pain management after open thoracotomy and the incidence of chronic postthoracotomy pain in more than 500 patients at a tertiary center. J Clin Anesth. 2017;36:174–7.

    Article  CAS  PubMed  Google Scholar 

  60. Kinney MA, Jacob AK, Passe MA, Mantilla CB. Increased risk of postthoracotomy pain syndrome in patients with prolonged hospitalization and increased postoperative opioid use. Pain Res Treat. 2016. https://doi.org/10.1155/2016/7945145.

    Article  CAS  Google Scholar 

  61. Diatchenko L, Slade G, Nackley A, Bhalang K, Sigurdsson A, Belfer I, et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum Mol Genet. 2005;14(1):135.

    Article  CAS  PubMed  Google Scholar 

  62. George SZ, Wallace MR, Wright T, Moser MW, Greenfield WH, Sack BK. Evidence for a biopsychosocial influence on shoulder pain: catastrophizing and catechol-O-methyltransferase (COMT) diplotype predict clinical pain ratings. Pain. 2008;136:53–61.

    Article  CAS  PubMed  Google Scholar 

  63. George SZ, Wu SS, Wallace MR, Moser MW, Wright TW, Farmer KW, et al. Biopsychosocial influence on shoulder pain: influence of genetic and psychological combinations on twelve-month postoperative pain and disability outcomes. Arthritis Care Res. 2016;11:1671–80.

    Article  Google Scholar 

  64. Rut M, Machoy-Mokrynska A, Reclawowicz D, Sloniewski P, Kurzawski M, Drozdzik M, et al. Influence of variation in the catechol-O-methyltransferase gene on the clinical outcome after lumbar spine surgery for one-level symptomatic disc disease: a on 176 cases. Acta Neurochir. 2014;156:245–52.

    Article  PubMed  Google Scholar 

  65. Tegeder I, Costigan M, Griffin R, Abele A, Belfer I, Schmidt H, et al. GTP cyclohydrolase and tetrahydrobiopterin regulate pain sensitivity and persistence. Nat Med. 2006;12(11):1269.

    Article  CAS  PubMed  Google Scholar 

  66. Jannetto PJ, Bratanow NC. Pain management in the 21st century: utilization of pharmacogenomics and therapeutic drug monitoring. Expert Opin Drug Metab Toxicol. 2011;7:745–52.

    Article  CAS  PubMed  Google Scholar 

  67. Ltsch J, Geisslinger G, Tegeder I. Genetic modulation of the pharmacological treatment of pain. Pharmacol Ther. 2009;124(2):168.

    Article  CAS  Google Scholar 

  68. Lloyd RA, Hotham E, Hall C, Williams M, Suppiah V. Pharmacogenomics and patient treatment parameters to opioid treatment in chronic pain: a focus on morphine, oxycodone, tramadol and fentanyl. Pain Med. 2016;0:1–19.

    Google Scholar 

  69. Song J-G, Shin JW, Lee EH, Choi DK, Bang JY, Chin JH, Choi IC. Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia. Eur J Cardio-Thor Surg. 2012;41:1078–82.

    Article  Google Scholar 

  70. Searle RD, Simpson MP, Simpson KH, Milton R, Bennett MI. Can chronic neuropathic pain following thoracic surgery be predicted during the post-operative period? Interact Cardiovasc Thorac Surg. 2009;9:999–1002.

    Article  PubMed  Google Scholar 

  71. Chaparro LE, Smith SA, Moore RA, Wiffen PJ, Gilron I. Pharmacotherapy for the prevention of chronic pain after surgery in adults. Cochrane Database Syst Rev. 2013;7:CD008307.

    Google Scholar 

  72. McNichol ED, Schumann R, Haroutounian S. A systematic review and meta-analysis of ketamine for the prevention of persistent post-surgical pain. Acta Anaesthesiol Scand. 2014;58:1199–213.

    Article  CAS  Google Scholar 

  73. Mendola C, Cammarota G, Netto R, Cecci G, Pisterna A, Ferrante D, et al. S(+)-ketamine for control of perioperative pain and prevention of post thoracotomy pain syndrome: a randomized, double-blind study. Minerva Anestesiol. 2012;78:757–66.

    CAS  PubMed  Google Scholar 

  74. Mishra A, Nar AS, Bawa A, Kaur G, Bawa S, Kaur G, Bawa S, Mishra S. Pregabalin in chronic post-thoracotomy pain. J Clin Diagn Res. 2013;7:1659–61.

    PubMed  PubMed Central  Google Scholar 

  75. Comez M, Celik M, Dostbil A, Aksoy M, Ahiskalioglu A, Erdem AF, et al. The effect of pre-emptive dexketoprofen + thoracal epidural on the chronic post-thoracotomy pain. Int J Clin Exp Med. 2015;8:8101–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  76. Ling X-M, Fang F, Zhang X-G, Ding M, Xue QA, Cang J. Effect of parecoxib combined with thoracic epidural analgesia on pain after thoracotomy. J Thorac Dis. 2016;8:880–7.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Baidya DK, Khanna P, Maitra S. Analgesic efficacy and safety of thoracic paravertebral and epidural analgesia for thoracic surgery: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2014;18:626–36.

    Article  PubMed  Google Scholar 

  78. Ding X, Jin S, Niu X, Ren H, Fu S, Li Q. A comparison of the analgesia efficacy and side effects of paravertebral compared with epidural blockade for thoracotomy: an updated meta-analysis. PLoS One. 2016;9:e96233.

    Article  CAS  Google Scholar 

  79. Yeung JHY, Gates S, Naidu BV, Wilson MJA, Gao Smith F. Parvertebral block versus thoracic epidural for patients undergoing thoracotomy. Cochrane Database Syst Rev. 2016;2:CD009121.

    PubMed  Google Scholar 

  80. Senturk M, Ozcan P, Talu G, Kiyan E, Camci E, Ozyalin S, et al. The effects of three different analgesia techniques on long-term postthoracotomy pain. Anesth Analg. 2002;94(1):11.

    Article  PubMed  Google Scholar 

  81. Tiippana E, Nilsson E, Kalso E. Post-thoracotomy pain after thoracic epidural analgesia: a prospective follow-up study. Acta Anaesthesiol Scand. 2003;47(4):433.

    Article  CAS  PubMed  Google Scholar 

  82. Obata H, Saito S, Fujita N, Fuse Y, Ishizaki K, Goto F. Epidural block with mepivacaine before surgery reduces long-term post-thoracotomy pain. Can J Anesth. 1999;46(12):1127.

    Article  CAS  PubMed  Google Scholar 

  83. Andrae MH, Andrae DA. Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery. Cochrane Database Syst Rev. 2012;10:CD007105.

    Google Scholar 

  84. Elshiekh MAF, Lo TTH, Shipolini AR, McCormack DJ. Does muscle-sparing thoracotomy as opposed to posterolateral thoracotomy result in better recovery. Interact Cardovasc Thorac Surg. 2013;16:60–7.

    Article  Google Scholar 

  85. Nosotti M, Baisi A, Mendogni P, Palleschi A, Tosi D, Rosso L. Muscle sparing versus posterolateral thoracotomy for pulmonary lobectomy: randomized controlled trial. Interact Cariovasc Thorac Surg. 2010;11:415–9.

    Article  Google Scholar 

  86. Nomori H, Horio H, Fuyuno G, Kobayashi R. Non-serratus-sparing antero-axillary thoracotomy with disconnection of anterior rib cartilage: improvement in postoperative pulmonary function and pain in comparison to posterolateral thoracotomy. Chest. 1997;111(3):572.

    Article  CAS  PubMed  Google Scholar 

  87. Athanassiadi K, Kakaris S, Theakos N, Skottis I. Muscle-sparing versus posterolateral thoracotomy: a prospective study. Eur J Cardiothorac Surg. 2007;31(3):496.

    Article  PubMed  Google Scholar 

  88. Furrer M, Rechsteiner R, Eigenmann V, Signer C, Althaus U, Ris HB. Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints. Eur J Cardiothorac Surg. 1997;12(1):82.

    Article  CAS  PubMed  Google Scholar 

  89. Stammberger U, Steinacher C, Hillinger S, Schmid RA, Kinsbergen T, Weder W. Early and long-term complaints following video-assisted thoracoscopic surgery: evaluation in 173 patients. Eur J Cardiothorac Surg. 2000;18(1):7.

    Article  CAS  PubMed  Google Scholar 

  90. Bertrand PC, Regnard JF, Spaggiari L, Levi JF, Magdeleinat P, Guibert L, et al. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann Thorac Surg. 1996;61(6):1641.

    Article  CAS  PubMed  Google Scholar 

  91. Hutter J, Miller K, Moritz E. Chronic sequels after thoracoscopic procedures for benign diseases. Eur J Cardiothorac Surg. 2000;17(6):687.

    Article  CAS  PubMed  Google Scholar 

  92. Handy JR, Asaph JW, Douville EC, Ott GY, Grunkemeier GL, Wu Y. Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy? Eur J Cardiothorac Surg. 2010;37:451–5.

    PubMed  Google Scholar 

  93. Bendixen M, Jergensen OD, Kronborg C, Andersen C, Licht PB. Postoperative pain and quality of life after video assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomized controlled trial. Lancet Oncol. 2016;17:836–44.

    Article  PubMed  Google Scholar 

  94. Noromi H, Cong Y, Sugimura H. Limited thoracotomy for segmentectomy: a comparison of postoperative pain with thoracoscopic lobectomy. Surg Today. 2016;46:1243–8.

    Article  Google Scholar 

  95. Yamashita Y, Mukaida H, Harada H, Tsubokawa N. Post-thoracotomy pain and long-term survival associated with video-assisted thoracic surgery lobectomy methods for clinical T1N0 lung cancer: a patient -oriented, prospective cohort study. Eur J Cardo-Thor Surg. 2013;44:e71–6.

    Article  Google Scholar 

  96. Benedetti F, Amanzio M, Casadio C, Filosso PL, Molinatti M, Oliaro A, et al. Postoperative pain and superficial abdominal reflexes after posterolateral thoracotomy. Ann Thorac Surg. 1997;64(1):207.

    Article  CAS  PubMed  Google Scholar 

  97. Benedetti F, Vighetti S, Ricco C, Amanzio M, Bergamasco L, Casadio C, et al. Neurophysiologic assessment of nerve impairment in posterolateral and muscle-sparing thoracotomy. J Thorac Cardiovasc Surg. 1998;115(4):841.

    Article  CAS  PubMed  Google Scholar 

  98. Rogers ML, Henderson L, Mahajan RP, Duffy JP. Preliminary findings in the neurophysiological assessment of intercostal nerve injury during thoracotomy. Eur J Cardiothorac Surg. 2002;21(2):298.

    Article  CAS  PubMed  Google Scholar 

  99. Maguire MF, Latter JA, Mahajan R, Beggs FD, Duffy JP. A study exploring the role of intercostal nerve damage in chronic pain after thoracic surgery. Eur J Cardiothorac Surg. 2006;29(6):873.

    Article  PubMed  Google Scholar 

  100. Wildgaard K, Ringsted TK, Ravn J, Werner MU, Kehlet H. Late sensory changes following chest drain insertion during thoracotomy. Acta Anaesthesiol Scand. 2013;57:776–83.

    Article  CAS  PubMed  Google Scholar 

  101. Cerfolio RJ, Price TN, Bryant AS, Sale Bass C, Bartolucci AA. Intracostal sutures decrease the pain of thoracotomy. Ann Thorac Surg. 2003;76(2):407.

    Article  PubMed  Google Scholar 

  102. Cerfolio RJ, Bryant AS, Patel B, Bartolucci AA. Intercostal muscle flap reduces the pain of thoracotomy: a prospective randomized trial. J Thorac Cardiovasc Surg. 2005;130(4):987.

    Article  PubMed  Google Scholar 

  103. Cerfolio RJ, Bryant AS, Maniscalco LM. A nondivided intercostal muscle flap further reduces pain of thoracotomy: a prospective randomized trial. Ann Thorac Surg. 2008;85(6):1901.

    Article  PubMed  Google Scholar 

  104. Hong K, Bae M, Han S. Subcostal closure technique for prevention of postthoracotomy pain syndrome. Asian Cardiovasc Thorac Ann. 2016;24:681–6.

    Article  PubMed  Google Scholar 

  105. Lu Q, Han Y, Cao W, Lei J, Wan Y, Fang Z, et al. Comparison of non-divided intercostal muscle flap and intercostal nerve cryoanalgesia treatments for post-oesophagectomy neuropathic pain control. Eur J Cardiothorac Surg. 2013;43:e64–70.

    Article  PubMed  Google Scholar 

  106. Visagan R, McCormack DJ, Shipolini AR, Jarral OA. Are intracostal sutures better than pericostal sutures for closing a thoracotomy? Interact Cardiovasc Thorac Surg. 2012;14:807–15.

    Article  PubMed  PubMed Central  Google Scholar 

  107. Allama AM. Intercostal muscle flap for decreasing pain after thoracotomy: a prospective randomized trial. Ann Thorac Surg. 2010;89:195–9.

    Article  PubMed  Google Scholar 

  108. Koop O, Gries A, Eckert S, Ellermeier S, Hoksch B, Branscheid D, Beshay M. The role of intercostal nerve preservation in pain control after thoracotomy. Eur J Cardiothorac Surg. 2013;43:808–12.

    Article  PubMed  Google Scholar 

  109. Koryllos A, Althaus A, Poels M, Joppich R, Lefering R, Wappler F, et al. Impact of paravertebral neurectomy on post thoracotomy pain syndrome after thoracotomy in lung cancer patients: a randomized controlled trial. J Thorac Dis. 2016;8:2427–33.

    Article  PubMed  PubMed Central  Google Scholar 

  110. Garcia-Tirado J, Rieger-Reyes C. Suture techniques of the intercostal space in thoracotomy and their relationship with post thoracotomy pain: a systematic review. Arch Bronconeumol. 2012;48:22–8.

    Article  PubMed  Google Scholar 

  111. Ji R-R, Xu Z-Z, Gao Y-J. Emerging targets in neuroinflammation-driven chronic pain. Nat Rev. 2014;13:533–48.

    CAS  Google Scholar 

  112. Huh Y, Ji R-R, Chen G. Neuroinflammation, bone marrow stem cells, and chronic pain. Front Immunol. 2017;8:1–9.

    Article  CAS  Google Scholar 

  113. Wildgaard K, Ringsted TK, Hansen HJ, Petersen RH, Werner MU, Kehlet H. Quantitative sensory testing of persistent pain after video-assisted thoracic surgery lobectomy. Br J Anaesth. 2012;108:126–33.

    Article  CAS  PubMed  Google Scholar 

  114. Wildgaard K, Ringsted TK, Aasvang EK, Ravn J, Werner MU, Kehlet H. Neurophysiological characterization of persistent postthoracotomy pain. Clin J Pain. 2012;28:136–42.

    Article  PubMed  Google Scholar 

  115. Mamet J, Klukinov M, Yaksh TL, Malkmus SA, Williams S, Harris S, et al. Single intrathecal administration of the transcription factor decoy AYX1 prevents acute and chronic pain after incisional, inflammatory or neuropathic injury. Pain. 2014;155:322–33.

    Article  CAS  PubMed  Google Scholar 

  116. Salvat E, Schweitzer B, Massard G, Meyer N, de Blay F, Muller A, Barrot M. Effects of β2 agonists on post-thoracotomy pain incidence. Eur J Pain. 2015;19:1428–36.

    Article  CAS  PubMed  Google Scholar 

  117. Humble SR, Dalton AJ, Li L. A systematic review of therapeutic interventions to reduce acute and chronic post-surgical pain after amputation, thoracotomy or mastectomy. Eur J Pain. 2015;19:451–65.

    Article  CAS  PubMed  Google Scholar 

  118. Brulotte V, Ruel MM, Lavontaine E. Impact of pregabalin on the occurrence of postthoracotomy pain syndrome: a randomized trial. Reg Anesth Pain Med. 2015;40:262–9.

    Article  CAS  PubMed  Google Scholar 

  119. Poobalan A, Bruce J, Smith WCS, King P, Krukowski Z, Chambers WA. A review of chronic pain after inguinal herniorrhaphy. Clin J Pain. 2003;19(1):48.

    Article  PubMed  Google Scholar 

  120. Granot M. Can we predict persistent postoperative pain by testing preoperative experimental pain? Curr Opin Anaesthesiol. 2009;22(3):425.

    Article  PubMed  Google Scholar 

  121. Weissman-Fogel I, Granovsky Y, Crispel Y, Ben-Nun A, Best L, Yarnitsky D, et al. Enhanced presurgical pain temporal summation response predicts post-thoracotomy pain intensity during the acute postoperative phase. J Pain. 2009;10(6):628.

    Article  PubMed  Google Scholar 

  122. Yarnitsky D, Crispel Y, Eisenberg E, Granovsky Y, Ben-Nun A, Sprecher E, et al. Prediction of chronic post-operative pain: pre-operative DNIC testing identifies patients at risk. Pain. 2008;138(1):22.

    Article  PubMed  Google Scholar 

  123. Tawfic Q, Kumar K, Pirani Z, Armstrong K. Prevention of chronic post-surgical pain: the importance of early identification of risk factors. J Anesth. 2017. http://doi.10.1007/s00540-017-2339-x.

  124. Katz J, Weinrib A, Fashler SR, Katznelzon R, Shah BR, Ladak SSJ, et al. The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain. J Pain Res. 2015;8:695–702.

    Article  PubMed  PubMed Central  Google Scholar 

  125. Clarke H, Poon M, Weinrib A, Katznelson R, Wentlandt K, Katz J. Preventive analgesia and novel strategies for the prevention of chronic post-surgical pain. Drugs. 2015;75:339–51.

    Article  CAS  PubMed  Google Scholar 

  126. DiMarco AF, Oca O, Renston JP. Lung herniation. A cause of chronic chest pain following thoracotomy. Chest. 1995;107(3):877.

    Article  CAS  PubMed  Google Scholar 

  127. Bennett M, Attal N, Backonja M, Baron R, Bouhassira D, Freynhagen R, et al. Using screening tools to identify neuropathic pain. Pain. 2007;127(3):199.

    Article  PubMed  Google Scholar 

  128. O’Connor A, Dworkin R. Treatment of neuropathic pain: an overview of recent guidelines. Am J Med. 2009;122(10 Suppl):S22.

    Article  PubMed  Google Scholar 

  129. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Syst Rev. 2007;4:CD005454.

    Google Scholar 

  130. Attal N, Cruccu G, Haanp M, Hansson P, Jensen TS, Nurmikko T, et al. EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol. 2006;13(11):1153.

    Article  CAS  PubMed  Google Scholar 

  131. Dworkin R, O’Connor A, Backonja M, Farrar J, Finnerup N, Jensen T, et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 2007;132(3):237.

    Article  CAS  PubMed  Google Scholar 

  132. Neuropathic pain – pharmacological management. The pharmacological management of neuropathic pain in adults in non-specialist settings. NICE clinical guideline 173. 2013. http://guidance.nice.org.uk/CG173.

  133. Sansone P, Passavanti MB, Fiorelli A, Aurilio C, Colella U, De Nardis L, et al. Efficacy of the topical 5% lidocaine medicated plaster in the treatment of chronic post-thoracotomy neuropathic pain. Pain Manag. 2017;7:189–96.

    Article  PubMed  Google Scholar 

  134. Knezevic NN, Rana MV, Czarnocki P, Anantamongkol U. Reprogramming of in situ spinal cord stimulator for covering newly developed postthoracotomy pain. J Clin Anesth. 2015;27:411–5.

    Article  PubMed  Google Scholar 

  135. Freynet A, Falcoz P. Is transcutaneous electrical nerve stimulation effective in relieving postoperative pain after thoracotomy? Interact Cardiovasc Thorac Surg. 2010;10(2):283.

    Article  PubMed  Google Scholar 

  136. Solak O, Tuma A, Pekcolaklar A, Metin M, Sayar A, Solak O, Gurses A. Transcutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomized prospective study. Thorac Cardiovasc Surg. 2007;55:182–5.

    Article  CAS  PubMed  Google Scholar 

  137. Fiorelli A, Morgillo F, Milione R, Pace MC, Passavanti MB, Laperuta P, Aurilio C, Santini M. Control of post-thoracotomy pain by transcutaneous electrical nerve stimulation: effect on serum cytokine levels, visual analogue scale, pulmonary function and medication. Eur J Cardiothorac Surg. 2012;41:861–8.

    Article  PubMed  Google Scholar 

  138. MacPherson H, Vertosick EA, Foster NE, Lewith G, Linde K, Sherman KJ, et al. The persistence of effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. 2017;158:784–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  139. Fabregat G, Asensio-Samper JM, Palmisani S, Villanueva-Perez VL, De Andres J. Subcutaneous botulinum toxin for chronic post-thoracotomy pain. Pain Pract. 2013;13:233–4.

    Article  Google Scholar 

  140. Rashid S, Fields AR, Baumrucker SJ. Subcutaneous botulinum toxin injection for post-thoracotomy pain syndrome in palliative care: a case report. Am J Hosp Palliat Med. 2018;35:511–3.

    Article  Google Scholar 

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  1. Department of Anesthesia and Family Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada

    Peter MacDougall

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    Peter Slinger

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MacDougall, P. (2019). Chronic Post-thoracotomy Pain. In: Slinger, P. (eds) Principles and Practice of Anesthesia for Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-00859-8_61

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