Sex Differences in Chronic Postsurgical Pain after Open Thoracotomy

Area of Science:

• Pain Research
• Surgical Outcomes
• Sex and Gender Differences in Health

Background:

• Chronic postsurgical pain (CPSP) is a significant concern following major surgical procedures.
• Understanding factors influencing CPSP incidence is crucial for improving patient care.
• Previous research has not fully elucidated sex-specific differences in CPSP after thoracotomy.

Purpose of the Study:

• To determine the incidence of chronic postsurgical pain (CPSP) in women undergoing open thoracotomy.
• To compare patient and procedural variables between women and men to identify potential contributing factors to CPSP.
• To investigate the role of psychological measures and preoperative pain in sex-based differences in CPSP.

Main Methods:

• An observational cohort study was conducted across ten university-affiliated hospitals.
• Data were collected from 96 women and 137 men scheduled for open thoracotomy.
• Pain history, psychological assessments, health status, catastrophizing scores, and clinical data were recorded, with CPSP diagnosed at 4 months post-surgery.

Main Results:

• The incidence of CPSP was significantly higher in women (53.1%) compared to men (38.0%) (p = 0.023).
• Women reported worse baseline psychological measures, including mental state perception (p = 0.01), depression (p = 0.006), and catastrophizing (p < 0.001).
• Women also reported increased preoperative pain in both the operative area (p = 0.011) and other regions (p = 0.030).

Conclusions:

• Physician-diagnosed chronic postsurgical pain occurs more frequently in women after thoracotomy.
• Sex and gender represent important variables that should be integrated into future clinical research on surgical pain.
• These findings underscore the need for sex- and gender-informed approaches to pain management in surgical patients.