Identifying Patients at High Risk of Chronic Pain After Video-Assisted Thoracoscopic Surgery Using Thermal Quantitative Sensory Testing

J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt A):2406-2411. doi: 10.1053/j.jvca.2022.03.015. Epub 2022 Mar 24.

Abstract

Objective: To examine whether perioperative thermal quantitative sensory testing could be used to identify patients at high risk of chronic pain after video-assisted thoracoscopic surgery (VATS).

Design: A single-center, prospective, observational study.

Setting: At the Peking University People's Hospital.

Participants: A total of 111 patients scheduled to undergo VATS were enrolled.

Interventions: Quantitative sensory testing was conducted at the anterior intercostal incision prior to surgery and after chest tube removal.

Measurements and main results: The patient's chronic pain was assessed at 3 months after surgery using a questionnaire. The incidence of chronic pain was 35 out of 107 evaluable patients (32.7%). Among the 35 patients with chronic pain, 26 had features characteristic of neuropathic pain (74.3%). Compared to the patients without chronic pain, subjects with chronic pain had a significantly greater perioperative change in cold pain threshold (CPT; p = 0.032), but not cold detection threshold, warm detection threshold, and hot pain threshold . In the multivariate regression, perioperative CPT change was associated with chronic pain after VATS (odds ratio = 1.043, p = 0.026).

Conclusions: Chronic pain after VATS is typically neuropathic. The change in perioperative CPT at the incision site may help to identify patients at higher risk of chronic pain after VATS.

Keywords: Chronic postoperative pain; neuropathic pain; quantitative sensory testing; video-assisted thoracoscopic surgery.

Publication types

  • Observational Study

MeSH terms

  • Chronic Pain* / diagnosis
  • Chronic Pain* / epidemiology
  • Chronic Pain* / etiology
  • Humans
  • Lung Neoplasms* / surgery
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / etiology
  • Prospective Studies
  • Thoracic Surgery, Video-Assisted / adverse effects