Acute and chronic neuropathic pain profiles after video-assisted thoracic surgery

Abstract

Acute postsurgical pain, probably including acute neuropathic pain (ANeP), starts at the early postoperative period, and chronic postsurgical pain including chronic neuropathic pain (CNeP) persists at least 3 months after surgery. Although it must be important for prevention and treatment of acute and chronic postoperative pain to reveal the time course of postoperative neuropathic characteristics, a neuropathic pain profile after surgery has not been evaluated. Pain status at the surgical site in adult patients who underwent video-assisted thoracic surgery (VATS) for lung cancer was prospectively assessed until 12 months after surgery. Neuropathic characteristics were assessed using the Douleur Neuropathique 4 (DN4) questionnaire until 6 days after surgery and the DN2 questionnaire throughout the study. Twenty-seven patients were enrolled in this study. Pain intensity at surgical sites were significantly higher at 1 and 6 days after surgery during resting state, and were also significantly higher at 3, 6, and 12 months after surgery during movement than those before surgery. The incidence of ANeP was 33.3% at 1 day, and 18.5% at 6 days after surgery. The incidence of CNeP decreased to 12.5% at 3 months, 5.0% at 6 months, and 0.0% at 12 months after surgery. The number of neuropathic characteristics, assessed by DN2 scores, significantly increased at 1 and 6 days after surgery, compared to those before surgery. DN2 scores at 3, 6, and 12 months after surgery, however, showed no significant differences compared to those before surgery. In patients with acute postsurgical pain, 20% to 30% of patients show ANeP characteristics, and the incidence of CNeP gradually decreases after VATS in patients with chronic postsurgical pain.

Impact of surgical technique and analgesia on clinical outcomes after lung transplantation

“…Location and extension of surgical incision, number of chest drainage tubes, institution of hypothermia, administration of glucocorticoids, and anesthetic drug administration can all impact magnitude of acute pain. [ 11 , 12 ] Following lung transplantation the management of acute pain is important in order to facilitate respiratory weaning. When analyzing qualitative pain scale, T access was associated with worse pain scores (considerable pain and very severe pain), whilst there were no significant differences on pain scores between C incision and median S. Single lung transplantation and age were protective factors for considerable and very severe pain.…”

Postoperative pain and the gut microbiome

“…Acute and persistent post-surgical pain (see below) are often accompanied by a neuropathic component ( Takenaka et al, 2020 ). This can be related to any of the above mentioned pathophysiological processes, but nerve injury specific to an anatomical location (e.g.…”

Mengenal Nyeri Neuropatik Akut Pasca Seksio Sesarea

“…Untuk mengetahui apakah nyeri neuropatik ini berlangsung secara akut, penilaian dengan kuisoner DN4 atau DN2 dilakukan sebelum pembedahan dan pada hari 1 dan 6 sesudah pembedahan, sementara untuk mengevaluasi apakah nyeri berlangsung secara kronik dilakukan penilaian pada bulan 3, 6, dan 12 setelah pembedahan. 17 Penelitian lain juga menilai ANP dengan kuesioner DN4, di mana nyeri dievaluasi sebelum pembedahan dan setidaknya 2 jam setelah pembedahan dan pada hari kedua pascabedah. 18…”