[Evaluation of postoperative pain intensity related to post-thoracotomy pain syndrome occurring after video-assisted thoracic surgery lobectomy for lung cancer].

Abstract

BACKGROUND:

We conducted a retrospective study to evaluate the relationship between post-thoracotomy pain syndrome (PTPS) and early postoperative analgesia with multimodal analgesia administered via a combination of patient-controlled epidural analgesia (PCEA) and nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who had undergone video-assisted lobectomy for lung cancer.

METHODS:

A total of 73 adult patients were divided into 2 groups: group A included 12 patients (16.4%) with PTPS, and group B included 61 patients without PTPS. All patients received postoperative multimodal analgesia via a combination of NSAIDs and PCEA with a mixture of 2 microg x ml(-1) fentanyl and 1.5 mg x ml(-1) ropivacaine. For statistical analyses, unpaired t-test, Mann-Whitney test and chi square test were used and considered P significant if lower than 0.05.

RESULTS:

Pain intensity was measured on a 100-mm non-graduated visual analogue scale (VAS), and it was significantly greater in group A (8 mm) than that in group B (2 mm). There was no significant difference between groups in pain intensity during movement, with a VAS score of 33 mm in group A and 35 mm in group B. The number of PCEA bolus injections given to patients was significantly higher in group A (3 times) than in group B (2 times). The duration of PCEA was also significantly longer in group A (4 days) than in group B (3 days). There was no significant difference in the rate of NSAIDs usage between the 2 groups

CONCLUSIONS:

This study demonstrated a significant difference in early postoperative pain intensity between patients with PTPS and those without. We conclude that there is a possibility of intervention in the early postoperative period in patients who underwent thoracic surgery.

• Authors: Seiji Kajiyama, Hirotsugu Miyoshi, Takahiro Kato, Masashi Kawamoto
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 63 Issue 4 Pg. 391-5 (Apr 2014) ISSN: 0021-4892 [Print] Japan
• PMID: 24783601 (Publication Type: Journal Article)

Chemical References

• Amides
• Analgesics
• Anti-Inflammatory Agents, Non-Steroidal
• Ropivacaine
• Fentanyl

Topics

• Aged
• Amides (administration & dosage)
• Analgesia, Epidural (methods)
• Analgesia, Patient-Controlled (methods)
• Analgesics (administration & dosage)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
• Drug Therapy, Combination
• Female
• Fentanyl (administration & dosage)
• Humans
• Lung Neoplasms (surgery)
• Male
• Middle Aged
• Pain Measurement
• Pain, Postoperative (diagnosis, drug therapy, physiopathology)
• Pneumonectomy
• Postoperative Care
• Retrospective Studies
• Ropivacaine
• Severity of Illness Index
• Syndrome
• Thoracic Surgery, Video-Assisted