title: Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia.
abstract: OBJECTIVE
  Thoracotomy is one of the most painful surgical incisions. Little is known, however, about the effect of type of anaesthesia on chronic post-thoracotomy pain syndrome (CPTS). We therefore compared the incidence of CPTS after total intravenous anaesthesia (TIVA) and inhalation anaesthesia.
  
  
  METHODS
  Patients (n = 366) were prospectively randomized into two groups: Group I (n = 173) received TIVA (propofol + remifentanil) and Group II (n = 170) received inhalation anaesthesia with sevoflurane. We assessed acute pain on postoperative days 1, 3 and 5, and the prevalence of CPTS at 3 and 6 months using a numerical rating scale (NRS).
  
  
  RESULTS
  The prevalence of CPTS was significantly lower in patients receiving TIVA than in those receiving inhalation anaesthesia at 3 months (38.2% versus 56.5%, P = 0.001) and at 6 months (33.5% versus 50.6%, P = 0.002), respectively. Moreover, allodynia-like pain was significantly less common in the TIVA group at 3 (P = 0.021) and 6 months (P = 0.032). NRS score of acute pain, however, did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  TIVA with propofol and remifentanil may reduce the incidence of CPTS at 3 and 6 months.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
authors.forename: Jun-Gol
authors.initials: JG
authors.lastname: Song
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Shin
authors.forename: Eun Ho
authors.initials: EH
authors.lastname: Lee
authors.forename: Dae Kee
authors.initials: DK
authors.lastname: Choi
authors.forename: Ji Youn
authors.initials: JY
authors.lastname: Bang
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Chin
authors.forename: In Cheol
authors.initials: IC
authors.lastname: Choi
mesh_terms: D059787:Acute Pain / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000769:Anesthesia, Inhalation / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002908:Chronic Disease; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D000077208:Remifentanil; D000077149:Sevoflurane; D013908:Thoracotomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000700:Analgesics; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol