A Potential Link Between Preoperative Inflammation Biomarkers and Acute Postoperative Pain Following VATS

Postoperative pain is common after video-assisted thoracic surgery (VATS). Recent evidence suggest that preoperative inflammatory biomarkers might be associated to chronic postoperative pain following major surgery, but the association between preoperative inflammation and acute pain after VATS have not been examined. This observational cohort study aimed to investigate the association between preoperative inflammatory biomarkers and acute postoperative pain in lung cancer patients undergoing VATS.

Preoperative plasma samples from cancer patients scheduled for VATS were analyzed for 92 inflammatory markers using the Olink Bioscience inflammation panel. Postoperative pain was measured during the first 48 hours using a numerical rating scale (0 to 10 point scale). Principal component analysis and orthogonal partial least square discriminant analysis was used to identify important inflammatory markers and combined with preoperative pain and postoperative opioid usage to predict postoperative pain using a multiple linear regression model.

The current study included 92 patients and 41 inflammatory biomarkers passing quality control. Orthogonal Partial Least Square Discriminant Analysis identified 16 important markers. An initial prediction model explained 27.2% of postoperative pain variability, while a condensed model using backwards elimination, explained 34.3% of postoperative pain variability. The condensed model included the inflammatory biomarkers 4E-BP1, STAMBP, MCP-2, VEGFA, and adjusted for postoperative opioid consumption.

The current study is the first to demonstrate an association between preoperative inflammatory biomarkers, opioid consumption, and acute postoperative pain after VATS in patients with lung cancer. Future studies are needed to confirm these findings.