[Evaluation of postoperative pain intensity related to post-thoracotomy pain syndrome occurring after video-assisted thoracic surgery lobectomy for lung cancer].
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.
Seiji
S
Kajiyama
Hirotsugu
H
Miyoshi
Takahiro
T
Kato
Masashi
M
Kawamoto
D000368:Aged; D000577:Amides / Q000008:administration & dosage; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D011013:Pneumonectomy; D011182:Postoperative Care; D012189:Retrospective Studies; D000077212:Ropivacaine; D012720:Severity of Illness Index; D013577:Syndrome; D020775:Thoracic Surgery, Video-Assisted
D000577:Amides; D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000077212:Ropivacaine; D005283:Fentanyl