title: Effects of β2 agonists on post-thoracotomy pain incidence.
abstract: BACKGROUND
  Pre-clinical research has shown β2 -adrenoceptors to be essential for the antiallodynic action of antidepressant drugs in murine models of neuropathic pain and that sustained treatment with β2 -agonists has an antiallodynic action. Here, we clinically investigated whether chronic β2 -agonist treatments may influence the incidence of post-thoracotomy chronic pain, defined as pain that recurs or persists along a thoracotomy scar more than 2 months after surgery, either neuropathic or non-neuropathic.
  
  
  METHODS
  We conducted an epidemiological study on patients operated by thoracotomy. Demographic data, medical history and treatments concomitant to the surgery were recorded at a follow-up visit. Information on perioperative treatments was collected from the anaesthesia records and confirmed by the patients. In patients with pain at the surgery level, post-thoracotomy chronic pain was assessed by clinical examination and numeric scale. Physical examination and DN4 questionnaire were used to discriminate neuropathic and non-neuropathic chronic pain at scar level.
  
  
  RESULTS
  One hundred and eighty-nine patients were included. Eighty-one patients reported persisting thoracic pain, with neuropathic characteristics in 58 of them (30% of the 189 patients). The most common chronic drugs during the perioperative period were inhaled β2 -agonists (28.6%). The chronic use of β2 -agonists was an independent predictor of thoracic neuropathic pain (but not of non-neuropathic pain) and was associated with a five-fold decrease in the relative incidence of neuropathic pain [OR = 0.19 (0.06-0.45)].
  
  
  CONCLUSIONS
  These data suggest a possible influence of chronic β2 -agonist treatments on neuropathic pain secondary to thoracotomy. This apparent preventive effect of β2 -agonist treatments should warrant controlled clinical trials.
authors.affiliation: Centre d'Evaluation et de Traitement de la Douleur, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Salvat
authors.affiliation: Département d'Anesthésie-Réanimation Chirurgicale, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Schweitzer
authors.affiliation: Département de Pathologies Thoraciques, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Massard
authors.affiliation: Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
authors.forename: N
authors.initials: N
authors.lastname: Meyer
authors.affiliation: Département de Pathologies Thoraciques, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: de Blay
authors.affiliation: Centre d'Evaluation et de Traitement de la Douleur, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Muller
authors.affiliation: Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique, France.
authors.forename: M
authors.initials: M
authors.lastname: Barrot
mesh_terms: D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology* / Q000517:prevention & control; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D013908:Thoracotomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists