Incidence and risk factors for chronic postsurgical pain following video-assisted thoracoscopic surgery: a retrospective study

Abstract

Background Video-assisted thoracoscopic surgery (VATS) has been widely used as an alternative for thoracotomy, but the reported incidence of chronic postsurgical pain (CPSP) following VATS varied widely. The purpose of this study was to investigate the incidence and risk factors for CPSP after VATS. Methods We retrospectively collected preoperative demographic, anesthesiology, and surgical factors in a cohort of patients undergoing VATS between January 2018 and October 2020. Patients were interviewed via phone survey for pain intensity, and related medical treatment 3 months after VATS. Univariate and multivariate analysis were used to explore independent risk factors associated with CPSP. Results 2348 patients were included in our study. The incidence of CPSP after VATS were 43.99% (n = 1033 of 2348). Within those suffering CPSP, 14.71% (n = 152 of 1033) patients reported moderate or severe chronic pain. Only 15.23% (n = 23 of 152) patients with moderate to severe chronic pain sought active analgesic therapies. Age < 65 years (OR 1.278, 95% CI 1.057–1.546, P = 0.011), female (OR 1.597, 95% CI 1.344–1.898, P < 0.001), education level less than junior school (OR 1.295, 95% CI 1.090–1.538, P = 0.003), preoperative pain (OR 2.564, 95% CI 1.696–3.877, P < 0.001), consumption of rescue analgesia postoperative (OR 1.248, 95% CI 1.047–1.486, P = 0.013), consumption of sedative hypnotic postoperative (OR 2.035, 95% CI 1.159–3.574, P = 0.013), and history of postoperative wound infection (OR 5.949, 95% CI 3.153–11.223, P < 0.001) were independent risk factors for CPSP development. Conclusions CPSP remains a challenge in clinic because half of patients may develop CPSP after VATS. Trial registration Chinese Clinical Trial Registry (ChiCTR2100045765), 2021/04/24

Prevalence and Predictors of Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Surgery: A Systematic Review and Meta-analysis

“…Thereafter, 183 records were carefully reviewed to ensure compliance with the inclusion criteria. Ultimately, 17 studies [10][11][12][20][21][22][23][24][25][26][27][28][29][30][31][32][33], comprising 10,525 patients who underwent VATS, were included in this study (Fig. 1).…”

Transbronchial Lung Cryobiopsy for Diffuse Parenchymal Lung Disease

“…It has been reported to occur in 15% (365/2,396) in one case series and 44% (1,033/2,348) in another with 6.5% (152/2,348) in the moderate to severe range. 55 56…”

Nomogram prediction of chronic postsurgical pain in patients with lung adenocarcinoma after video-assisted thoracoscopic surgery: A prospective study

“…Nonetheless, the highest incidence of CPSP can still reach 37.4% with a VATS lobectomy ( 12 ). The occurrence of CPSP causes a severe disturbance in patients’ emotional state and sleep quality, leading to a number of psychological issues that immensely impact their prognosis and quality of life ( 9 , 13 , 14 ). Hence, identifying the predictive factors associated with CPSP after VATS will help clinicians achieve targeted prevention and treatment to support patients in re-establishing confidence and improving their quality of life ( 15 ).…”

“…In recent years, a number of retrospective studies have investigated the associated risk factors for the development of CPSP after VATS, including body mass index (BMI), history of pain, and acute postoperative pain ( 13 , 14 , 16 – 19 ). Further, studies have indicated that microRNAs (miRNAs) in the peripheral blood of patients with chronic neuropathic pain are closely associated with chronic neuropathic pain ( 20 – 22 ).…”

“…Moreover, studies have confirmed that increased BMI is an independent risk factor for CPSP ( 24 ). History of chronic pain refers to the baseline level of pain preoperatively, and retrospective studies have demonstrated that preoperative pain increases the risk of the development of CPSP ( 14 ). In addition to preoperative pain, postoperative VAS pain scores on days 1–3 were also positively associated with the occurrence of CPSP after VATS ( 17 ).…”