Newly Published
Pain Medicine  |   March 2017
A Prospective Study of Chronic Pain after Thoracic Surgery
Author Notes
  • From the Department of Anesthesia (E.O.B., T.J.B.), Department of Biostatistics (E.O.B.), Department of Cardiothoracic Surgery (K.R.P., J.K.), and Department of Pharmacology (T.J.B.), University of Iowa, Iowa City, Iowa; and Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey (A.S.).
  • This article is featured in "This Month in Anesthesiology," page 1A. Corresponding article is on page XXX.
    This article is featured in "This Month in Anesthesiology," page 1A. Corresponding article is on page XXX.×
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Submitted for publication September 16, 2016. Accepted for publication January 27, 2017.
    Submitted for publication September 16, 2016. Accepted for publication January 27, 2017.×
  • Acknowledgments: The authors appreciate the help of Alicia Manning, A.D.N. (Department of Anesthesia, University of Iowa, Iowa City, Iowa), Pam Jacobs, R.N. (Department of Anesthesia, University of Iowa, Iowa City, Iowa), and Joan Ricks-McGillin, R.N., B.S.N., (Department of Cardiothoracic Surgery, University of Iowa, Iowa City, Iowa) for the patient enrollment. We also appreciate edits suggested by Paul Casella, M.F.A. (Department of Internal Medicine, University of Iowa, Iowa City, Iowa).
    Acknowledgments: The authors appreciate the help of Alicia Manning, A.D.N. (Department of Anesthesia, University of Iowa, Iowa City, Iowa), Pam Jacobs, R.N. (Department of Anesthesia, University of Iowa, Iowa City, Iowa), and Joan Ricks-McGillin, R.N., B.S.N., (Department of Cardiothoracic Surgery, University of Iowa, Iowa City, Iowa) for the patient enrollment. We also appreciate edits suggested by Paul Casella, M.F.A. (Department of Internal Medicine, University of Iowa, Iowa City, Iowa).×
  • Research Support: Supported by grant No. NS080110-01A1 from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (Bethesda, Maryland). Support was also provided by the Department of Anesthesia at the University of Iowa (Iowa City, Iowa).
    Research Support: Supported by grant No. NS080110-01A1 from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (Bethesda, Maryland). Support was also provided by the Department of Anesthesia at the University of Iowa (Iowa City, Iowa).×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Correspondence: Address correspondence to Dr. Bayman: University of Iowa Hospitals and Clinics, 6439 JCP, 200 Hawkins Drive, Iowa City, Iowa 52242-1081. emine-bayman@uiowa.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Pain Medicine / Pain Medicine / Thoracic Anesthesia
Pain Medicine   |   March 2017
A Prospective Study of Chronic Pain after Thoracic Surgery
Anesthesiology Newly Published on March 2, 2017. doi:10.1097/ALN.0000000000001576
Anesthesiology Newly Published on March 2, 2017. doi:10.1097/ALN.0000000000001576
Abstract

Background: The goal of this study was to detect the predictors of chronic pain at 6 months after thoracic surgery from a comprehensive evaluation of demographic, psychosocial, and surgical factors.

Methods: Thoracic surgery patients were enrolled 1 week before surgery and followed up 6 months postsurgery in this prospective, observational study. Comprehensive psychosocial measurements were assessed before surgery. The presence and severity of pain were assessed at 3 and 6 months after surgery. One hundred seven patients were assessed during the first 3 days after surgery, and 99 (30 thoracotomy and 69 video-assisted thoracoscopic surgery, thoracoscopy) patients completed the 6-month follow-up. Patients with versus without chronic pain related to thoracic surgery at 6 months were compared.

Results: Both incidence (P = 0.37) and severity (P = 0.97) of surgery-related chronic pain at 6 months were similar after thoracotomy (33%; 95% CI, 17 to 53%; 3.3 ± 2.1) and thoracoscopy (25%; 95% CI, 15 to 36%; 3.3 ± 1.7). Both frequentist and Bayesian multivariate models revealed that the severity of acute pain (numerical rating scale, 0 to 10) is the measure associated with chronic pain related to thoracic surgery. Psychosocial factors and quantitative sensory testing were not predictive.

Conclusions: There was no difference in the incidence and severity of chronic pain at 6 months in patients undergoing thoracotomy versus thoracoscopy. Unlike other postsurgical pain conditions, none of the preoperative psychosocial measurements were associated with chronic pain after thoracic surgery.