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. 2018 May;10(5):2898-2907.
doi: 10.21037/jtd.2018.05.25.

Risk factors of neuropathic pain after thoracic surgery

Takahiro Homma  1 , Yoshinori Doki  1 , Yutaka Yamamoto  1 , Toshihiro Ojima  1 , Yoshifumi Shimada  1 , Naoya Kitamura  1 , Naoki Yoshimura  1
Affiliations

Risk factors of neuropathic pain after thoracic surgery

Takahiro Homma et al. J Thorac Dis. 2018 May.

Abstract

Background: This study aimed to clarify the incidence and risk factors of neuropathic pain after thoracic surgery, focusing especially on patients who underwent complete video-assisted thoracoscopic surgery (VATS).

Methods: We retrospectively identified 185 patients who underwent thoracic surgery at our hospital over a 2-year period. Logistic regression analysis was used to analyze the association of various factors with postoperative neuropathic pain.

Results: Forty-eight (25.9%) patients developed postoperative neuropathic pain, and 9 (18.8%) of these patients reported persistent pain 1 year postoperatively. The median interval from surgical treatment to the onset of neuropathic pain was 7 days, and the duration was 50 days. Multivariate logistic regression analysis revealed a significant positive correlation between postoperative neuropathic pain and preoperative use of hypnotic medication [odds ratio (OR), 5.45; 95% confidence interval (CI); 2.52-12.17] and duration of surgery ≥2.5 hours (OR, 2.72; 95% CI, 1.27-6.09), and a significant negative association with the complete VATS approach (OR, 0.18; 95% CI, 0.073-0.42).

Conclusions: Preoperative use of hypnotic medication, the thoracotomy approach, and duration of surgery ≥2.5 hours are associated with increased risk of neuropathic pain after thoracic surgery. The complete VATS approach could decrease the incidence of postoperative neuropathic pain, regardless of the duration of surgery.

Keywords: Neuropathic pain; thoracic surgery; thoracotomy; video-assisted thoracic surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Postoperative pain management. POD, postoperative day; eGFR, estimated glomerular filtration rate; VAS, visual analog scale.
See this image and copyright information in PMC

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