Hetmann Fredrik, Kongsgaard Ulf E, Sandvik Leiv, Schou-Bredal Inger
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences.
Division of Emergencies and Critical Care, Department of Anaesthesiology, Oslo University Hospital; Medical Faculty, University of Oslo.
J Pain Res. 2017 Mar 21;10:663-668. doi: 10.2147/JPR.S126639. eCollection 2017.
Persistent pain affects a large proportion of patients after thoracotomy and is associated with sensory disturbances. The objective of this prospective study was to investigate the time course of pain and sensory disturbances over a 12-month period.
Patients scheduled for thoracotomy were recruited. Data were collected on the day before surgery, including baseline characteristics and the presence of any preoperative pain. At 6- and 12-month follow-ups, data on pain were collected using the Brief Pain Inventory-Short Form, and perceived sensory disturbances around the thoracotomy scar were recorded from a self-exploration test.
At 12 months after surgery, 97 patients had complete data including baseline and 6-and 12-month measurements. Almost half of the patients reported post-thoracotomy pain at the follow-ups. However, 20% of the patients not reporting post-thoracotomy pain at 6 months did report it at 12 months. Between 40% and 60% of patients experienced some kind of sensory disturbance at 6 months. A small decline in some kind of sensory disturbance was reported by 20%-50% of patients at 12 months.
A proportion of patients experienced either resolved or delayed onset of pain. Sensory changes were strongly associated with post-thoracotomy pain syndrome, but were also present in a large proportion of patients without it.
开胸术后，持续性疼痛影响着很大一部分患者，并与感觉障碍相关。这项前瞻性研究的目的是调查12个月内疼痛和感觉障碍的时间进程。
招募计划接受开胸手术的患者。在手术前一天收集数据，包括基线特征和术前是否存在疼痛。在6个月和12个月的随访中，使用简明疼痛评估量表简表收集疼痛数据，并通过自我探索测试记录开胸手术疤痕周围的感觉障碍情况。
术后12个月时，97例患者有完整数据，包括基线以及6个月和12个月时的测量数据。几乎一半的患者在随访中报告了开胸术后疼痛。然而，6个月时未报告开胸术后疼痛的患者中有20%在12个月时报告了疼痛。40%至60%的患者在6个月时经历了某种感觉障碍。20%至50%的患者在12个月时报告某种感觉障碍有小幅下降。
一部分患者经历了疼痛缓解或延迟发作。感觉变化与开胸术后疼痛综合征密切相关，但在很大一部分没有该综合征的患者中也存在。
