TY - JOUR

T1 - Chronic pain in adults after thoracotomy in childhood or youth

AU - Kristensen, A D

AU - Pedersen, T A L

AU - Hjortdal, V E

AU - Jensen, T S

AU - Nikolajsen, L

PY - 2010/1

Y1 - 2010/1

N2 - BACKGROUND: Chronic pain is common after thoracotomy with reported prevalence rates of 20-60%. The pain may be caused by damage to the intercostal nerves during surgery. Some studies have suggested that young age at the time of surgery reduces the risk of developing chronic pain. So far, no studies have examined if children and adolescents develop chronic pain after thoracotomy.METHODS: Eighty-eight patients, mean (sd) age 39.3 (7.7) yr, who underwent thoracotomy between the age of 0 and 25 yr were asked to recall the duration of postoperative pain and-if pain was still present-to describe intensity and character of pain. In addition, all patients underwent quantitative sensory testing.RESULTS: Fourteen patients (16%) recalled that their postoperative pain had lasted for more than 3 months: one (3.2%) patient in the youngest group (0-6 yr), seven (19.4%) patients in the age group 7-12 yr, and six (28.5%) patients in the age group 13-25 yr (P=0.03). Three out of the 14 patients, who were 11, 11, and 18 yr of age at the time of surgery, still had pain at present. Quantitative sensory testing revealed hypo- and hyperphenomena in most patients, including those with persistent pain. Tactile detection thresholds and pressure detection thresholds were significantly higher on the operated side when compared with the contralateral side (n=88; P<0.001).CONCLUSIONS: The risk of developing chronic pain after thoracotomy seems to be lower if surgery is performed at a young age. Pain after thoracotomy is likely to be of neuropathic origin.

AB - BACKGROUND: Chronic pain is common after thoracotomy with reported prevalence rates of 20-60%. The pain may be caused by damage to the intercostal nerves during surgery. Some studies have suggested that young age at the time of surgery reduces the risk of developing chronic pain. So far, no studies have examined if children and adolescents develop chronic pain after thoracotomy.METHODS: Eighty-eight patients, mean (sd) age 39.3 (7.7) yr, who underwent thoracotomy between the age of 0 and 25 yr were asked to recall the duration of postoperative pain and-if pain was still present-to describe intensity and character of pain. In addition, all patients underwent quantitative sensory testing.RESULTS: Fourteen patients (16%) recalled that their postoperative pain had lasted for more than 3 months: one (3.2%) patient in the youngest group (0-6 yr), seven (19.4%) patients in the age group 7-12 yr, and six (28.5%) patients in the age group 13-25 yr (P=0.03). Three out of the 14 patients, who were 11, 11, and 18 yr of age at the time of surgery, still had pain at present. Quantitative sensory testing revealed hypo- and hyperphenomena in most patients, including those with persistent pain. Tactile detection thresholds and pressure detection thresholds were significantly higher on the operated side when compared with the contralateral side (n=88; P<0.001).CONCLUSIONS: The risk of developing chronic pain after thoracotomy seems to be lower if surgery is performed at a young age. Pain after thoracotomy is likely to be of neuropathic origin.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Child

KW - Child, Preschool

KW - Chronic Disease

KW - Female

KW - Humans

KW - Hyperesthesia/etiology

KW - Hypesthesia/etiology

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Middle Aged

KW - Pain Measurement/methods

KW - Pain Threshold

KW - Pain, Postoperative/diagnosis

KW - Physical Stimulation/methods

KW - Postoperative Period

KW - Thoracotomy/adverse effects

KW - Touch

KW - Young Adult

U2 - 10.1093/bja/aep317

DO - 10.1093/bja/aep317

M3 - Journal article

C2 - 19915188

VL - 104

SP - 75

EP - 79

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 1

ER -