The epidemiology of chronic postsurgical pain after video-assisted thoracic surgery (VATS-CPSP) in China: a...

Chronic postsurgical pain (CPSP) after video-assisted thoracic surgery (VATS) has been a focus for research and clinical improvement for decades. However, large-scale epidemiological reports from prospective studies are still lacking. The goal of this study was to present the CPSP profiles after VATS from a nationwide survey.

Patients who were scheduled for VATS at the participating centres were prospectively enrolled in this multicentre observational study between August 1^st and September 30^th, 2022. Comprehensive assessments of demographic, pain, clinical, and psychological factors were performed before surgery. During surgery, surgical factors, drainage tubes and anaesthesiologic factors were recorded. Postoperative pain was assessed via NRS (Numeric Rating Scale), BPI-9 (Brief Pain Inventory 9 questions) and DN-4 (Douleur Neuropathique 4 questions, as Neuropathic pain four questions in English) interviews on postoperative days 1-3, at discharge, and 3 and 6 months after surgery. Phone interviews were performed at 3- and 6-month follow-ups.

A total of 904 patients were recruited, 882 of whom completed the 6-month follow-up and were analysed for CPSP. The incidence rates of CPSP 3 and 6 months after VATS were 38.3% [95% confidence interval (CI): 35.2-41.6%] and 26.8% (95% CI: 23.9-29.8%), respectively, with 10.7% and 4.7% of the cohort (94 and 41 of the 882 patients, respectively) reporting moderate to severe pain (NRS ≥3), respectively. In contrast to previous results for thoracotomy, only 0.5% of the patients complained of neuropathic pain in this study. Acute postoperative pain was significantly related to the incidence of CPSP.

CPSP is still a common problem after thoracic surgery (6-month incidence of 26.8%). However, the characteristics of pain may have changed as the surgery becomes less invasive.