Chronic Pain After Lung Resection: Risk Factors, Neuropathic Pain, and Quality of Life

Fiorelli, Silvia; Cioffi, Luigi; Menna, Cecilia; Ibrahim, Mohsen; Blasi, R. A. De; Rendina, Erino Angelo; Rocco, Monica; Massullo, Domenico

doi:10.1016/j.jpainsymman.2020.03.012

Cited by 38 publications

(38 citation statements)

References 29 publications

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“…Chronic post-surgical pain is defined as recurring or persisting pain for more than 2 months after surgery. The reported incidence of chronic postsurgical pain (CPSP) is between 20 and 60% among VATS ( 45 ). Erector spinae plane block with 25 mg of levobupivacaine and 40 mg of triamcinolone has been used safely and effectively to treat CPSP in a case series of seven patients undergoing different surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Ultrasound-Guided, Bi-Level, Erector Spinae Plane Block With Different Doses of Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial

Gao

Zhao

et al. 2021

Front. Med.

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Background: The anesthetic characteristics of ultrasound-guided bi-level erector spinae plane block (ESPB) plus dexmedetomidine (Dex) remain unclear. We compared the efficacy and safety of ultrasound-guided bi-level ESPB plus different doses of Dex in patients undergoing video-assisted thoracic surgery (VATS).Methods: One-hundred eight patients undergoing VATS were randomized into three groups: R group (n = 38, 15 ml of 0.375% ropivacaine with 0.1 mg/kg dexamethasone), RD1 group (n = 38, 15 ml of 0.375% ropivacaine plus 0.5 μg/kg DEX with 0.1 mg/kg dexamethasone) and RD2 group (n = 38, 15 ml of 0.375% ropivacaine plus 1.0 μg/kg DEX with 0.1 mg/kg dexamethasone). The primary outcome was the pain 12 h after surgery. Secondary outcomes included the Prince Henry Hospital Pain Score; hemodynamics; consumption of sufentanil; anesthetized dermatomal distribution; recovery time; rescue analgesia; satisfaction scores of patients and surgeon; quick recovery index; adverse effects; the prevalence of chronic pain and quality of recovery.Results: The visual analog scale (VAS) and the Prince Henry pain score were significantly lower in both the RD1 and RD2 groups during the first 24 h after surgery (P < 0.05). Both VAS with coughing and the Prince Henry pain score were significantly lower in the RD2 group than in the RD1 group 8–24 h after surgery (P < 0.05). Both heart rate and mean arterial pressure were significantly different from T2 to T6 in the RD1 and RD2 groups (P < 0.05). The receipt of remifentanil, propofol, Dex, and recovery time was significantly reduced in the RD2 group (P < 0.05). The requirement for sufentanil during the 8–72 h after surgery, less rescue medication, and total press times were significantly lower in the RD2 group (P < 0.05). The time to the first dose of rescue ketorolac was significantly longer in the RD2 group (P < 0.05). Further, anal exhaust, removal of chest tubes, and ambulation were significantly shorter in the RD2 group (P < 0.05). The incidence of tachycardia, post-operative nausea and vomiting, and chronic pain was significantly reduced in the RD2 group, while the QoR-40 score was significantly higher in the RD2 group (P < 0.05).Conclusions: Pre-operative bi-level, single-injection ESPB plus 1 μg/kg DEX provided superior pain relief and long-term post-operative recovery for patients undergoing VATS.Clinical Trial Registration:http://www.chictr.org.cn/searchproj.aspx.

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Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Ultrasound-Guided, Bi-Level, Erector Spinae Plane Block With Different Doses of Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial

Gao

Zhao

et al. 2021

Front. Med.

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“…La RATS presenta resultados prometedores en cuanto a la reducción de dolor agudo postoperatorio por tratarse de una técnica mínimamente invasiva [4], [13]- [15]. El abordaje multimodal del dolor en la cirugía torácica debe considerarse mandatorio debido a las múltiples aferencias sensitivas tras la agresión quirúrgica [5], [16], con el objetivo de reducir al máximo las potenciales complicaciones del dolor agudo postoperatorio, así como la cronificación del dolor [11], [15], [16]. La técnica regional por excelencia en la toracotomía ha sido, tradicionalmente, la analgesia epidural torácica [17].…”

Section: Discussionunclassified

Abordaje anestésico en cirugía torácica asistida por robot: estudio de cohorte unicéntrico

Alvarez-Villegas¹,

Campistol²,

Puig³

et al. 2021

Rev. chil. anest.

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“…to be less painful compared with a regular thoracotomy because it is less invasive, however, incidence and severity of CPSP have been reported to be similar. 8 CPSP after thoracic surgery has been associated with a lower overall quality of life, [9][10][11][12][13] and chronic pain is associated with an increased utilisation of healthcare, increased absenteeism and decreased work-related effectiveness. [14][15][16] The direct health-related costs of chronic pain have been reported to be US$11 846 annually, 17 and the indirect work-related costs have been reported to be US$29 617 annually.…”

Section: Open Accessmentioning

confidence: 99%

Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

et al. 2021

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IntroductionChronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods heterogeneous and the methodological quality questionable. Systematic reviews and meta-analyses are therefore needed to summarise the evidence.Methods and analysisThe reporting of this protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We will include retrospective and prospective studies with a follow-up of at least 3 months reporting patient-related factors and surgery-related factors for any adult population. Randomised controlled trials will be included if they report on prognostic factors for CPSP after lung or pleural surgery. We will exclude case series, case reports, literature reviews, studies that do not report results for lung or pleural surgery separately and studies that modified the treatment or prognostic factor based on pain during the observation period. MEDLINE, Scopus, Web of Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature reviews will be searched. Independent pairs of two reviewers will assess studies in two stages based on the PICOTS criteria. We will use the Quality in Prognostic Studies tool for the quality assessment and the CHARMS-PF checklist for the data extraction of the included studies. The analyses will all be conducted separately for each identified prognostic factor. We will analyse adjusted and unadjusted estimated measures separately. When possible, evidence will be summarised with a meta-analysis and otherwise narratively. We will quantify heterogeneity by calculating the Q and I2 statistics. The heterogeneity will be further explored with meta-regression and subgroup analyses based on clinical knowledge. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guideline 28.Ethics and disseminationEthical approval will not be necessary, as all data are already in the public domain. Results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42021227888.

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Chronic Pain After Lung Resection: Risk Factors, Neuropathic Pain, and Quality of Life

Cited by 38 publications

References 29 publications

The Efficacy and Safety of Ultrasound-Guided, Bi-Level, Erector Spinae Plane Block With Different Doses of Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial

The Efficacy and Safety of Ultrasound-Guided, Bi-Level, Erector Spinae Plane Block With Different Doses of Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial

Abordaje anestésico en cirugía torácica asistida por robot: estudio de cohorte unicéntrico

Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

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