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Chapter 30 - Post-thoracotomy Pain

from Part VI - Misc

Published online by Cambridge University Press:  01 December 2023

Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Post-thoracotomy pain syndrome (PTPS) is a musculoskeletal pain condition defined by the IASP as pain that recurs or persists along a thoracotomy incision at least two months following the surgical procedure and the pain must also not be related to metastasis or other treatments. The prevalence/incidence of PTPS varies greatly from 33% to 91%. The exact pathologic mechanism for developing PTPS is unknown and is still being investigated but is believed to be a combination of somatic, visceral, and neuropathic pain components, which are often complicated with central sensitization. Diagnostic criteria require a detailed medical history with temporal and clinical components. Treatment includes the development of new surgical techniques to prevent the development of PTPS, anesthetic techniques (e.g., SAPB, TEA), pharmacological treatment (e.g., gabapentin and pregabalin, NMDA antagonists), and interventional treatment (e.g., thermal radio frequency ablation, neuromodulation/nerve stimulation).

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Maloney, J, Wie, C, Pew, S et al. Post-thoracotomy pain syndrome. Curr Pain Headache Rep. 2022;26(9):677681. https://doi.org/10.1007/s11916-022-01069-z.CrossRefGoogle ScholarPubMed
Khelemsky, Y, Noto, CJ. Preventing post-thoracotomy pain syndrome. Mt Sinai J Med. 2012;79(1):133139. https://doi.org/10.1002/MSJ.21286.CrossRefGoogle ScholarPubMed
Hopkins, KG, Rosenzweig, M. Post-thoracotomy pain syndrome: Assessment and intervention. Clin J Oncol Nurs. 2012;16(4):365370. https://doi.org/10.1188/12.CJON.365-370.CrossRefGoogle ScholarPubMed
Arends, S, Böhmer, AB, Poels, M et al. Post-thoracotomy pain syndrome: Seldom severe, often neuropathic, treated unspecific, and insufficient. Pain Rep. 2020;5(2):e810. https://doi.org/10.1097/PR9.0000000000000810.CrossRefGoogle ScholarPubMed
El-Hag-Aly, MA, Hagag, MG, Allam, HK. If post-thoracotomy pain is the target, integrated thoracotomy is the choice. Gen Thorac Cardiovasc Surg. 2019;67(11):955961. https://doi.org/10.1007/S11748-019-01126-2/TABLES/4.CrossRefGoogle ScholarPubMed
Khalil, AE, Abdallah, NM, Bashandy, GM, Kaddah, TAH. Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain. J Cardiothorac Vasc Anesth. 2017;31(1):152158. https://doi.org/10.1053/J.JVCA.2016.08.023.CrossRefGoogle ScholarPubMed
Elsabeeny, WY, Ibrahim, MA, Shehab, NN, Mohamed, A, Wadod, MA. Serratus anterior plane block and erector spinae plane block versus thoracic epidural analgesia for perioperative thoracotomy pain control: A randomized controlled study. J Cardiothorac Vasc Anesth. 2021;35(10):29282936. https://doi.org/10.1053/J.JVCA.2020.12.047.CrossRefGoogle ScholarPubMed
Reyad, RM, Shaker, EH, Ghobrial, HZ et al. The impact of ultrasound-guided continuous serratus anterior plane block versus intravenous patient-controlled analgesia on the incidence and severity of post-thoracotomy pain syndrome: A randomized, controlled study. Eur J Pain. 2020;24(1):159170. https://doi.org/10.1002/EJP.1473.CrossRefGoogle ScholarPubMed
Gaber, S, Saleh, E, Elshaikh, S et al. Role of perioperative pregabalin in the management of acute and chronic post-thoracotomy pain. Open Access Maced J Med Sci. 2019;7(12):19741978. https://doi.org/10.3889/OAMJMS.2019.556.CrossRefGoogle ScholarPubMed
Fawzi, HM, El-Tohamy, SA. Effect of perioperative oral pregabalin on the incidence of post-thoracotomy pain syndrome. Ain-Shams J Anaesthesiology. 2014;7(2):143. https://doi.org/10.4103/1687-7934.133350.CrossRefGoogle Scholar
Mendola, C, Cammarota, G, Netto, R et al. S(+)-ketamine for control of perioperative pain and prevention of post thoracotomy pain syndrome: A randomized, double-blind study. Minerva Anestesiol. 2012;78(7):757766. https://pubmed.ncbi.nlm.nih.gov/22441361/.Google ScholarPubMed
Israel, JE, St Pierre, S, Ellis, E et al. Ketamine for the treatment of chronic pain: A comprehensive review. Health Psychol Res. 2021;9(1):112. https://doi.org/10.52965/001C.25535.CrossRefGoogle ScholarPubMed
Abd-Elsayed, A, Lee, S, Jackson, M. Radiofrequency ablation for treating resistant intercostal neuralgia. Ochsner J. 2018;18(1):9193. https://doi.org/10.1043/TOJ-17-0043.Google ScholarPubMed
Engel, AJ. Utility of intercostal nerve conventional thermal radiofrequency ablations in the injured worker after blunt trauma. Pain Physician. 2012;15:E711E718. https://pubmed.ncbi.nlm.nih.gov/22996865/.CrossRefGoogle ScholarPubMed
Theodosiadis, P, Grosomanidis, V, Samoladas, E, Chalidis, BE. Subcutaneous targeted neuromodulation technique for the treatment of intractable chronic postthoracotomy pain. J Clin Anesth. 2010;22(8):638641. https://doi.org/10.1016/J.JCLINANE.2009.10.018.CrossRefGoogle ScholarPubMed
McJunkin, TL, Berardoni, N, Lynch, PJ, Amrani, J. An innovative case report detailing the successful treatment of post-thoracotomy syndrome with peripheral nerve field stimulation. Neuromodulation Technol Neural Interface. 2010;13(4):311314. https://doi.org/10.1111/J.1525-1403.2010.00277.X.CrossRefGoogle ScholarPubMed
Graybill, J, Conermann, T, Kabazie, AJ, Chandy, S. Spinal cord stimulation for treatment of pain in a patient with post thoracotomy pain syndrome. Pain Physician. 2011;14(5):441445. https://pubmed.ncbi.nlm.nih.gov/21927048/.CrossRefGoogle Scholar
Wininger, KL, Bester, ML, Deshpande, KK. Spinal cord stimulation to treat postthoracotomy neuralgia: Non-small-cell lung cancer: A case report. Pain Manag Nurs. 2012;13(1):5259. https://doi.org/10.1016/J.PMN.2011.11.001.CrossRefGoogle ScholarPubMed
lo Bianco, G, Papa, A, Gazzerro, G et al. Dorsal root ganglion stimulation for chronic postoperative pain following thoracic surgery: A pilot study. Neuromodulation. 2021;24(4):774778. https://doi.org/10.1111/NER.13265.CrossRefGoogle ScholarPubMed

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