Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, The Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea.
Reg Anesth Pain Med. 2020 May;45(5):331-336. doi: 10.1136/rapm-2020-101292. Epub 2020 Mar 17.
The long-term incidence of chronic postsurgical pain (CPSP) after thoracic surgery has not yet been reported.
We retrospectively reviewed the electronic medical records of 4218 consecutive patients who underwent thoracic surgery for lung cancer between 2007 and 2016. We evaluated the long-term incidence of CPSP after thoracic surgery at intervals of 3 months for 36 months. A Cox proportional hazard regression analysis was performed to investigate the predictors of CPSP after thoracic surgery.
A total of 3200 patients were included in the analysis. Of these, 459 (14.3%) and 558 (17.4%) patients were diagnosed with CPSP within 3 and 36 months after surgery, respectively. Furthermore, the incidence of CPSP decreased over time. Additionally, 99 (3.1%) patients were newly diagnosed with CPSP at least 6 months after surgery. Female sex (HR 1.20, 95% CI 1.00 to 1.43; p=0.04), longer duration of surgery (HR 1.11, 95% CI 1.03 to 1.20; p<0.01), higher 11-point Numeric Rating Scale score at first outpatient visit after surgery (HR 1.29, 95% CI 1.24 to 1.34; p<0.001), postoperative chemotherapy (HR 1.55, 95% CI 1.26 to 1.90; p<0.001), and postoperative radiation therapy (HR 1.35, 95% CI 1.05 to 1.74; p=0.02) were significant predictors of CPSP for 36 months after surgery.
Our study showed a decreasing trend in the incidence of CPSP as well as delayed-onset or recurrent CPSP after thoracic surgery. A better understanding of the progression of CPSP after thoracic surgery may provide important information on its prediction and treatment.
胸外科手术后慢性术后疼痛(CPSP)的长期发生率尚未报道。
我们回顾性分析了 2007 年至 2016 年间连续 4218 例因肺癌行胸外科手术的患者的电子病历。我们在术后 3 个月至 36 个月的时间间隔内评估了胸外科手术后 CPSP 的长期发生率。采用 Cox 比例风险回归分析探讨胸外科手术后 CPSP 的预测因素。
共纳入 3200 例患者。其中,术后 3 个月和 36 个月时分别有 459(14.3%)和 558(17.4%)例患者诊断为 CPSP。此外,CPSP 的发生率随时间推移而降低。此外,至少有 99 例患者(3.1%)在术后至少 6 个月时被新诊断为 CPSP。女性(HR 1.20,95%CI 1.00 至 1.43;p=0.04)、手术时间较长(HR 1.11,95%CI 1.03 至 1.20;p<0.01)、术后首次门诊时 11 分制数字评分量表评分较高(HR 1.29,95%CI 1.24 至 1.34;p<0.001)、术后化疗(HR 1.55,95%CI 1.26 至 1.90;p<0.001)和术后放疗(HR 1.35,95%CI 1.05 至 1.74;p=0.02)是术后 36 个月时 CPSP 的显著预测因素。
本研究显示,胸外科手术后 CPSP 的发生率呈下降趋势,且存在迟发性或复发性 CPSP。更好地了解胸外科手术后 CPSP 的进展情况可能为其预测和治疗提供重要信息。