Danielsen Allan V, Andreasen Jan J, Dinesen Birthe, Hansen John, Petersen Kristian K, Duch Kirsten S, Simonsen Carsten, Arendt-Nielsen Lars
Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Eur J Pain. 2025 Mar;29(3):e4749. doi: 10.1002/ejp.4749. Epub 2024 Nov 4.
Persistent postsurgical pain (PPSP) following thoracic surgery affects 40%-60% of patients undergoing lung resection due to malignancies. Postoperative pain-related symptoms are common, leading to limitations in activities of daily living (ADL) and deterioration in physical function, which significantly impacts quality of life. Pain-related limitations are of interest, as postsurgical pain may present as a target for intervention to improve postoperative rehabilitation. This study aimed to evaluate the association between PPSP and ADL limitations during the first 12 postoperative months after surgery for lung cancer.
A total of 124 patients undergoing surgery for lung cancer were followed for 12 months. Every 2 months, participants reported ADL limitations attributed to PPSP. Cumulative pain impairment scores were calculated from reported limitations in 14 daily activities, and recovery trajectory patterns were analysed.
Daily activities most affected by PPSP were carrying bags, arm elevation, climbing stairs, cleaning floors and coughing, with >50% reporting limitations across all assessment times. Reported pain intensities were generally mild (NRS≤3), but still associated with significant impairment. Some recovery was observed in patients reporting pain at rest, but PPSP was consistently associated with higher cumulative pain impairment scores at all assessments during the 12-month follow-up period.
Findings indicate that persistent postsurgical pain, even of mild intensity, is associated with significant limitations in daily activities up to 12 months post-surgery. Some improvement in pain-related impairment was observed, although limitations remained significantly higher in patients reporting persistent postsurgical pain, as compared to pain-free patients.
Surgery remains a cornerstone in the treatment of early-stage lung cancer. Despite advances in minimally invasive techniques and rehabilitation, persisting postsurgical pain and pain-related limitations in daily activities may endure. This study investigated specifically the pain-related limitations in activities of daily living and described recovery trajectories during the first 12 postoperative months. Patients with persistent postsurgical pain experienced multiple limitations compared to pain-free patients. Although partial recovery was observed, impairments remained significant for up to 12 months after surgery.
胸外科手术后的持续性手术疼痛（PPSP）影响40%-60%因恶性肿瘤接受肺切除的患者。术后疼痛相关症状很常见，导致日常生活活动（ADL）受限和身体功能恶化，这对生活质量有显著影响。疼痛相关的限制值得关注，因为手术疼痛可能成为改善术后康复的干预目标。本研究旨在评估肺癌手术后12个月内PPSP与ADL限制之间的关联。
共对124例接受肺癌手术的患者进行了12个月的随访。每2个月，参与者报告因PPSP导致的ADL限制。根据14项日常活动中的报告限制计算累积疼痛损伤评分，并分析恢复轨迹模式。
受PPSP影响最大的日常活动是提包、手臂抬高、爬楼梯、拖地和咳嗽，在所有评估时间，超过50%的人报告有这些活动受限。报告的疼痛强度一般较轻（数字评分量表≤3），但仍与显著损伤相关。报告静息痛的患者有一定恢复，但在12个月的随访期内，所有评估中PPSP始终与较高的累积疼痛损伤评分相关。
研究结果表明，即使是轻度的持续性手术疼痛，在术后12个月内也与日常活动的显著限制有关。尽管观察到疼痛相关损伤有所改善，但与无疼痛患者相比，报告有持续性手术疼痛的患者的活动受限仍然显著更高。
手术仍然是早期肺癌治疗的基石。尽管微创技术和康复取得了进展，但持续性手术疼痛和日常活动中与疼痛相关的限制可能仍然存在。本研究专门调查了日常生活活动中与疼痛相关的限制，并描述了术后12个月内的恢复轨迹。与无疼痛患者相比，有持续性手术疼痛的患者经历了多种限制。尽管观察到部分恢复，但术后长达12个月损伤仍然显著。
