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Identifying Patients at High Risk of Chronic Pain After Video-Assisted Thoracoscopic Surgery Using Thermal
Guang Wang1, Miao He1, Xiao-Lin Ji1
1Department of Anesthesiology, Peking University People's Hospital, Beijing, China.
Objective:
To examine whether perioperative thermal quantitative sensory testing could be used to identify patients at high risk of chronic pain after video-assisted thoracoscopic surgery (VATS).
Design:
A single-center, prospective, observational study.
Setting:
At the Peking University People's Hospital.
Participants:
A total of 111 patients scheduled to undergo VATS were enrolled.
Interventions:
Quantitative sensory testing was conducted at the anterior intercostal incision prior to surgery and after chest tube removal.
Measurements And Main Results:
The patient's chronic pain was assessed at 3 months after surgery using a questionnaire. The incidence of chronic pain was 35 out of 107 evaluable patients (32.7%). Among the 35 patients with chronic pain, 26 had features characteristic of neuropathic pain (74.3%). Compared to the patients without chronic pain, subjects with chronic pain had a significantly greater perioperative change in cold pain threshold (CPT; p = 0.032), but not cold detection threshold, warm detection threshold, and hot pain threshold . In the multivariate regression, perioperative CPT change was associated with chronic pain after VATS (odds ratio = 1.043, p = 0.026).
Conclusions:
Chronic pain after VATS is typically neuropathic. The change in perioperative CPT at the incision site may help to identify patients at higher risk of chronic pain after VATS.
