Prevalence, Characteristics and Preoperative Predictors of Chronic Pain After Double-Lung Transplantation: A Prospective Cohort Study

Laurent, Quentin; Michel-Cherqui, Mireille; Szekély, Barbara; Glorion, Matthieu; Sage, Édouard; Trichereau, Julie; Fischler, Marc; Fessler, Julien; Guen, Morgan Le

doi:10.1053/j.jvca.2021.07.041

Cited by 11 publications

(12 citation statements)

References 26 publications

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“…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%

“…Based on the conventional meta-analyses, pre-operative pain, higher postoperative pain intensity, female sex and longer surgery duration were associated with a higher chronic post-surgical pain risk, and intercostal nerve block and video-assisted thoracic surgery with a lower chronic post-surgical pain risk. While trial sequential analysis showed adequate power of the meta-analyses for intercostal nerve block, postoperative pain intensity, pre- Wong [85] Wildgaard [84] Wang [82] Gandhi [57] Bayman [ Bayman [50] Blichfeldt-Eckhardt [51] Hetmann [60] Kar [9] Laurent [90] Gottschalk [ pooled all types of video-assisted thoracic surgery and found associations with chronic post-surgical pain after such surgery with: female sex; younger age; higher postoperative pain intensity; and longer surgery duration [26]. While we did find the association with chronic postsurgical pain for pre-operative pain, postoperative pain intensity and surgical approach, age had no significant effect.…”

Section: Discussionmentioning

confidence: 99%

“…Bayman [50] Blichfeldt-Eckhardt [51] Fiorelli [11] Gandhi [57] Homma [61] Kar [9] Laurent [90] Mongardon [71] Peng [92] Perttunen [73] Sugiyama [78] Wang [82] Wildgaard [83] Yoon [87] Zhao [89] Gottschalk [58] Hu [62] Bayman [50] Blichfeldt-Eckhardt [51] Fiorelli [11] Kar [9] Wang [82] Wong [85] Yoon [87] Zhao [89] Gottschalk [ Bayman [50] Blichfeldt-Eckhardt [51] Fiorelli [11] Furrer [55] Homma [61] Landreneau [66] Peng [92] Shanthanna [77] Sugiyama [78] Wang [81] Wildgaard [83] Yoon [87] Kirby [63] [25,26], we cannot conclude from the studies published so far that there is sufficient evidence to establish sex as a prognostic factor of chronic post-surgical pain after lung and pleural surgery.…”

Section: Discussionmentioning

confidence: 99%

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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

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

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“…However, only 9.1% took opioids. Concerning preoperative predictive factors for postoperative pain, the maximal preoperative pain score was the only independent factor identified [ 89 ].…”

Section: Resultsmentioning

confidence: 99%

New Aspects of Lung Transplantation: A Narrative Overview Covering Important Aspects of Perioperative Management

Fessler

Finet

Fischler

et al. 2022

Life

Self Cite

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The management of lung transplant patients has continued to evolve in recent years. The year 2021 was marked by the publication of the International Consensus Recommendations for Anesthetic and Intensive Care Management of Lung Transplantation. There have been major changes in lung transplant programs over the last few years. This review will summarize the knowledge in anesthesia management of lung transplantation with the most recent data. It will highlight the following aspects which concern anesthesiologists more specifically: (1) impact of COVID-19, (2) future of transplantation for cystic fibrosis patients, (3) hemostasis management, (4) extracorporeal membrane oxygenation management, (5) early prediction of primary graft dysfunction, and (6) pain management.

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“…In a recent prospective cohort study of 72 double LTx recipients, Laurent et al reported a high prevalence of chronic pain (68%). Indeed, it was primarily associated with mild pain intensity (83.3%) but has significantly affected patients’ quality of life and mental well being 19 …”

Section: Introductionmentioning

confidence: 99%

Regional analgesia for lung transplantation

Azem

Mangoubi

Zribi

et al. 2023

European Journal of Anaesthesiology

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Lung transplantation (LTx) is the definitive treatment for end-stage pulmonary disease. About 4500 LTxs are performed annually worldwide.It is considered challenging and complex surgery regarding anaesthesia and pain management. While providing adequate analgesia is crucial for patient comfort, early mobilisation and prevention of postoperative pulmonary complications, standardising an analgesic protocol is challenging due to the diversity of aetiologies, surgical approaches and the potential use of extracorporeal life support (ECLS).Although thoracic epidural analgesia is commonly considered the gold standard, concerns regarding procedural safety and its potential for devastating consequences have led physicians to seek safer analgesic modalities such as thoracic nerve blocks.The advantages of thoracic nerve blocks for general thoracic surgery are well established. However, their utility in LTx remains unclear.Considering paucity of relevant literature, this review aims to raise awareness about the literature gap in the field and highlight the need for further high-quality studies determining the effectiveness of available techniques.

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Prevalence, Characteristics and Preoperative Predictors of Chronic Pain After Double-Lung Transplantation: A Prospective Cohort Study

Cited by 11 publications

References 26 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

New Aspects of Lung Transplantation: A Narrative Overview Covering Important Aspects of Perioperative Management

Regional analgesia for lung transplantation

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