A retrospective study of open thoracotomies versus thoracoscopic surgeries for persistent postthoracotomy pain.
J Clin Anesth
; 35: 215-220, 2016 Dec.
Article
en En
| MEDLINE
| ID: mdl-27871525
ABSTRACT
OBJECTIVE:
Persistent thoracotomy pain syndrome (PTPS) is a recognized complication and is considered to be less after video-assisted thoracoscopic surgery (VATS) compared with open thoracic surgery (OTS). The primary objective was to compare the incidence of PTPS at 6 months. Secondary objectives were to compare the incidence of neuropathic pain between VATS and OTS and to report perioperative factors associated with the development of PTPS.METHODS:
This historical cohort study involved patient contact by a questionnaire regarding the presence of PTPS and its type. Patient, surgical, and analgesia factors were collected from health records, acute pain, and thoracic surgery databases. The data were analyzed using a multivariable logistic regression analysis, with results reported as adjusted odds ratio (OR) (95% confidence interval; P value).RESULTS:
Of 308 patients, 130 returned their questionnaire, and 106 responses were analyzed. The incidence of PTPS was 35% and 54% with VATS and OTS respectively, with an adjusted OR, 0.33 (95% confidence interval, 0.13-0.86), P= .024. The percentage of neuropathic pain was 18% and 48%, with VATS and OTS respectively, with an adjusted OR, 0.18 (0.04-0.85), P= .031. The diagnosis of cancer and previous chronic pain history were observed to be significantly associated with PTPS.CONCLUSIONS:
Our study indicates that PTPS is significantly more common and has a higher chance of being neuropathic with OTS. Despite being relatively less traumatic, VATS still carries a significant potential for PTPS. A diagnosis of cancer and history of previous pain are highly predictive of its development.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
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Toracotomía
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Cirugía Torácica Asistida por Video
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Dolor Crónico
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Analgesia
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Neoplasias
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Neuralgia
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Anesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2016
Tipo del documento:
Article