Post-Thoracotomy Pain Syndrome: Incidence, Neuropathic Component, and Risk Factors

Objective: Pain that recurs or persists at least two months after thoracotomy is defined as post-thoracotomy pain syndrome (PTPS), and neuropathic pain (NP) is expected to develop in approximately half of these patients. This study aimed to examine the frequency of PTPS, the neuropathic component of pain, and the effecting risk factors in patients who underwent thoracotomy. Methods: 862 patients who underwent thoracotomy were monitored between January 2010 and May 2013 at Gazi University Faculty of Medicine Hospital. The study continued with 277 patients who could be contacted by phone at least three months after the operation. In these patients, the presence of pain was questioned, if present, the severity of pain, NP and affecting risk factors were investigated. The pain severity and NP component were evaluated using the Numeric Rating Scale (NRS) and Douleur Neuropathique 4 (DN4) questionnaires, respectively. Results: Severe PTPS frequency after thoracotomy was found to be 19.1 % and NP was present in 53% of patients with NRS 3-10. As the severity of pain increased, the frequency of NP and analgesic drug consumption increased (p<0.05). As risk factors gender, age, operation duration and epidural analgesia application did not significantly affect the frequency and severity of PTPS and NP. As the time after the operation increased; PTSP frequency, neuropathic pain frequency and pain intensity were decreased (p<0.05). Conclusion: Severe PTPS is detected in approximately one in five patients who undergone thoracotomy and half of them had NP. The neuropathic component of pain increases as pain intensity increases and decreases as time passes after surgery. The development of PTPS and NP should be reduced by providing effective analgesia. Keywords: Thoracotomy, chronic pain, post-thoracotomy pain syndrome, neuropathic pain