Chronic post-thoracotomy pain - What is new in pathogenic mechanisms and strategies for prevention?

TY - JOUR

T1 - Chronic post-thoracotomy pain - What is new in pathogenic mechanisms and strategies for prevention?

AU - Wildgaard, Kim

AU - Kehlet, Henrik

PY - 2011/7

Y1 - 2011/7

N2 - Recently, the development of persistent postsurgical pain states has received much attention. As a model for understanding persistent postsurgical pain, thoracotomy and its minimal invasive counterpart, video-assisted thoracic surgery, have been investigated. The present article presents recent developments in pathophysiology of post-thoracotomy pain syndrome (PTPS) in regards to pre-, intra-, and postoperative factors. Although the literature is abundant with trials on PTPS, inadequate and inconsistent inclusion of relevant pre-, intra-, and postoperative factors is still problematic. Future trials delineating pain areas and assessing sensory dysfunction support the importance of nerve injury, but other factors are insufficiently investigated. Finally, there is a need for validated detailed procedure-specific questionnaires to assess the function and psychosocial consequences of PTPS.

AB - Recently, the development of persistent postsurgical pain states has received much attention. As a model for understanding persistent postsurgical pain, thoracotomy and its minimal invasive counterpart, video-assisted thoracic surgery, have been investigated. The present article presents recent developments in pathophysiology of post-thoracotomy pain syndrome (PTPS) in regards to pre-, intra-, and postoperative factors. Although the literature is abundant with trials on PTPS, inadequate and inconsistent inclusion of relevant pre-, intra-, and postoperative factors is still problematic. Future trials delineating pain areas and assessing sensory dysfunction support the importance of nerve injury, but other factors are insufficiently investigated. Finally, there is a need for validated detailed procedure-specific questionnaires to assess the function and psychosocial consequences of PTPS.

U2 - 10.1053/j.trap.2011.06.004

DO - 10.1053/j.trap.2011.06.004

M3 - Journal article

SN - 1084-208X

VL - 15

SP - 83

EP - 89

JO - Techniques in Regional Anesthesia and Pain Management

JF - Techniques in Regional Anesthesia and Pain Management

IS - 3

ER -