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

Wang, Guang; He, Miao; Ji, Xiaolin; Wang, Xiuli; Feng, Yi

doi:10.1053/j.jvca.2022.03.015

Cited by 4 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After removal of 166 records, 56 that met the eligibility criteria were included (Fig. 1) [9, 11, 50–103]. Of the 56 included studies, 28 (50%) were randomised controlled trials, 16 (29%) prospective observational studies and 12 (21%) retrospective observational studies.…”

Section: Resultsmentioning

confidence: 99%

Prognostic factors for chronic post‐surgical pain after lung and pleural surgery: a systematic review with meta‐analysis, meta‐regression and trial sequential analysis

et al. 2023

View full text Add to dashboard Cite

Chronic post-surgical pain is known to be a common complication of thoracic surgery and has been associated with a lower quality of life, increased healthcare utilisation, substantial direct and indirect costs, and increased long-term use of opioids. This systematic review with meta-analysis aimed to identify and summarise the evidence of all prognostic factors for chronic post-surgical pain after lung and pleural surgery. Electronic databases were searched for retrospective and prospective observational studies as well as randomised controlled trials that included patients undergoing lung or pleural surgery and reported on prognostic factors for chronic post-surgical pain. We included 56 studies resulting in 45 identified prognostic factors, of which 16 were pooled with a meta-analysis. Prognostic factors that increased chronic post-surgical pain risk were as follows: higher postoperative pain intensity (day 1, 0-10 score), mean difference (95%CI) 1.29 (0.62-1.95), p < 0.001; pre-operative pain, odds ratio (95%CI) 2.86 (1.94-4.21), p < 0.001; and longer surgery duration (in minutes), mean difference (95%CI) 12.07 (4.99-19.16), p < 0.001. Prognostic factors that decreased chronic post-surgical pain risk were as follows: intercostal nerve block, odds ratio (95%CI) 0.76 (0.61-0.95) p = 0.018 and video-assisted thoracic surgery, 0.54 (0.43-0.66) p < 0.001. Trial sequential analysis was used to adjust for type 1 and type 2 errors of statistical analysis and confirmed adequate power for these prognostic factors. In contrast to other studies, we found that age had no significant effect on chronic post-surgical pain and there was not enough evidence to conclude on sex. Meta-regression did not reveal significant effects of any of the study covariates on the prognostic factors with a significant effect on chronic post-surgical pain. Expressed as grading of recommendations, assessment, development and evaluations criteria, the certainty of evidence was high for pre-operative pain and video-assisted thoracic surgery, moderate for intercostal nerve block and surgery duration and low for postoperative pain intensity. We thus identified actionable factors which can be addressed to attempt to reduce the risk of chronic post-surgical pain after lung surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Prognostic factors for chronic post‐surgical pain after lung and pleural surgery: a systematic review with meta‐analysis, meta‐regression and trial sequential analysis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Our previous study reported the association between QST and self-reported pain and symptoms in young adults with irritable bowel syndrome 31 . Previous studies also applied QST to identify the risk of developing chronic pain among patients receiving thoracoscopic surgery as well as to determine the self-reported symptoms (ie, anxiety and depression) in different patient populations 50 – 52 . The QST and CPM profiles may serve as a biomarker for the pain to facilitate early detection of pain, function decline, and burdensome symptoms among older adults with HF.…”

Section: Discussionmentioning

confidence: 99%

Pain sensation and gut microbiota profiles in older adults with heart failure

Chen

Wang

Starkweather

et al. 2023

Interdisciplinary Nursing Research

View full text Add to dashboard Cite

Objectives: Patients with heart failure (HF) experience severe pain and may have altered pain sensation; however, the underlying mechanisms of these symptoms are not yet fully understood. Identifying pain sensation and genomic biomarkers of pain in older adults with HF is a critical step toward developing personalized interventions to improve pain management and outcomes. This study aimed to investigate the differences in pain sensation, gut microbiota, self-reported pain, and symptoms in older adults with and without HF. Methods: Twenty older adults with HF and age-matched healthy controls (HCs) were recruited in the Northeastern United States. Quantitative sensory testing and conditioned pain modulation were performed on the nondominant upper arm to detect the mechanical, thermal, and pressure pain thresholds and pain modulations. Stool samples were collected, and the 16S rRNA V4 gene region of stool samples was sequenced and processed using the Mothur 1.42.3 pipeline. Self-reported pain and symptoms were measured by the Brief Pain Inventory and the NIH Patient-reported Outcomes Measurement Information System. The associations between pain sensation, gut microbiota α-diversity indices, and pain and symptoms were explored using the Spearman correlations. Results: The HF and HC subjects' mean ages were 73.50 (SD = 8.33) and 67.10 (SD = 7.64), respectively. The HF subjects reported significantly higher pain intensity and interference, sleep disturbance, fatigue, anxiety, and depression than the HCs. The HF subjects also had a significantly lower level of physical function and participation in social roles and activities. Compared with the HCs, the HF subjects had significantly altered conditioned pain modulation heat effect and gut microbiota compositions and predicted metabolic functions. The Statistical Analysis Of Metagenomic Profiles indicated that the HF subjects had a significantly decreased cardiac muscle contraction pathway compared with the HCs. The correlation analysis showed that the quantitative sensory testing profiles and gut microbiota diversity index were significantly associated with pain and symptoms in older adults with HF. Conclusions: Older adults with HF had more severe self-reported pain and symptoms, altered pain sensation, and different gut microbiota composition and function compared with age-matched HCs. Pain sensation and gut microbiota may contribute to pain and symptoms in older adults with HF and could serve as biomarkers of pain and symptoms of HF. Further research with a larger sample size is warranted to confirm these findings.

show abstract

“…Wang and colleagues used QST to predict which patients would develop chronic pain following thoracic surgery [39]. Similarly, Dursteler and colleagues showed that low descending pain inhibition, i.e., low conditioned pain modulation (CPM), as assessed by QST was associated withincreased risk for persistent pain following knee replacement surgery [40].…”

Section: Qst In Precision Pain Managementmentioning

confidence: 99%

The Role of Quantitative Sensory Testing in Clinical Medicine and Research

Anastasi¹,

Capili²,

McMahon³

2022

J Clin Biomed Res

View full text Add to dashboard Cite

A healthy peripheral nervous system allows for perception of temperature, touch and vibration at normal levels of stimulation without hypersensitivity or pain and is a key determinant of quality of life. Quantitative sensory testing (QST) describes an array of noninvasive methods for quantifying sensory function and monitoring sensory loss among patients with or at-risk for peripheral neuropathy (PN). Like audiometry, QST quantifies patients’ subjective sensory experience with instrumentation that is precise and amenable to serial use. Thermal QST is the only diagnostic technology able to detect and quantify preclinical sensory deficit via direct patient feedback and merits wider use in clinical practice and research. A comprehensive QST assessment of 13 sensory parameters may be performed in an hour or less; abbreviated assessments take substantially less time. Although increasingly employed to evaluate sensation, define pain phenotypes, and predict outcomes in research studies and to monitor neurologic deficits in clinical practice, QST remains undervalued and underutilized possibly due to limited familiarity, experience, and understanding within the medical community and a lack of published standards regarding its use. This article is intended as a concise QST overview (with a focus on the use of thermal QST for the detection of small fiber abnormalities often associated with early PN) aimed at improving awareness of the unique role of QST in evaluating sensory function

show abstract

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

Cited by 4 publications

References 23 publications

Prognostic factors for chronic post‐surgical pain after lung and pleural surgery: a systematic review with meta‐analysis, meta‐regression and trial sequential analysis

Prognostic factors for chronic post‐surgical pain after lung and pleural surgery: a systematic review with meta‐analysis, meta‐regression and trial sequential analysis

Pain sensation and gut microbiota profiles in older adults with heart failure

The Role of Quantitative Sensory Testing in Clinical Medicine and Research

Contact Info

Product

Resources

About