Post-Operative Chronic Pain Control in Mediastinal Lymphomas in An Elderly Population: the Role of Physical Activity

Abstract

Thoracotomy is one of the most painful types of incision a patient can experience. Pain is a very complex pathophysiological entity. Neuronal pathophysiological mechanisms are integrated with the immunological response, which amplify inflammation and pain. Prolonged inflammation induces a pathological response of the immune-system and constantly stimulate the nociceptive pathways generating chronic pain. The mechanisms are particularly altered in lymphomas, where pain following chest surgery often becomes chronic and reduces the quality of life. In this study 51 elderly patients who had undergone a transthoracic biopsy to verify the suspect of mediastinal lymphoma were examined for pain reduction with oral opioids, effect of epidural analgesia and paravertebral block. Subsequently, patients underwent tensed torsion exercises, progressively intensified. After the first few days, patients walked progressively for 20 minutes a day. Once discharged a program of patients started aerobic exercises to increase muscle endurance and to strengthen the extensor muscles of the legs and of the upper limbs. The systemic administration of opioids is the simplest and most common method of providing analgesia for postoperative pain, but early mobilization, respiratory rehabilitation, and muscle toning exercises are excellent support devices both for physical and psychological recovery.

Neuronal P2X4 receptor may contribute to peripheral inflammatory pain in rat spinal dorsal horn

“…Pain is a striking and devastating symptom of many diseases affecting the physical and mental well-being (Noehren et al, 2015;Raffaeli et al, 2021). Several lines of evidence support that the main causating agents are inflammatory factors, malignant disorders as well as damages to the nervous system (Sica et al, 2019;Troiani et al, 2019). The condition may emerge in the form of allodynia, hyperalgesia or spontaneous pain states, in which the nociceptive threshold is markedly altered resulting in central sensitization (Majedi et al, 2018;Davies et al, 2019;Kuner and Kuner, 2021).…”