Assessment of chronic pain after thoracotomy: a 1-year prevalence study

The primary goal of this study was to investigate the incidence of chronic pain 1 year after a thoracotomy. Secondary goals were to determine which interventions and patient characteristics were associated with reports of chronic pain, to identify risk factors, to clarify the neuropathic component, and to determine the impact of chronic pain on daily life.

All 86 patients, who had undergone a posterolateral thoracotomy at our institution between October 2007 and March 2008, received a questionnaire 1 year after the surgical procedure and were contacted by phone 1 week later.

Sixty-five patients responded. Prevalence of chronic pain was 48%; among them 8 patients had neuropathic pain (12% of the whole group). Current, average, and maximal pain scale scores were 1.1±1.2, 1.3±1.3, and 3.4±1.7 (visual analog scale), respectively. Patients with chronic pain were about 10 years younger (P=0.07) and had a significantly less severe American Society of Anesthesiologists (ASA) score (29% grade I versus 17%, P=0.04). With regard to risk factors, age and ASA score were negatively correlated with chronic pain whereas number of drains was positively correlated to it. In most patients with pain (84%), activities of daily life were affected.

Chronic pain is common after thoracotomy and its neuropathic component is infrequent. As age, ASA scores, number of drains, and situations relating to daily life seem to play a role in pain occurrence, a multifaceted approach against the onset of chronic pain is advisable.