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Eur J Cardiothorac Surg 2006;29:800-805
© 2006 Elsevier Science NL

A questionnaire study investigating the prevalence of the neuropathic component of chronic pain after thoracic surgery

^a Department of Thoracic Surgery, Nottingham City Hospital Trust, Hucknall Road, Nottingham NG5 1PB, UK
^b Department of Anaesthesia, Nottingham City Hospital, Nottingham, UK

Received 25 November 2005; received in revised form 1 February 2006; accepted 3 February 2006.

^_* Corresponding author. Tel.: +44 115 9691169; fax: +44 115 8402605. (Email: mrmmaguire{at}hotmail.com).

Objective: Our questionnaire study set out to assess the prevalence of chronic pain after thoracic surgery, the contribution of the neuropathic component of chronic pain and the impact of chronic pain on patients’ lives. Methods: A questionnaire was sent to 1152 patients who had undergone thoracic surgery in our department between 7 months and 7 years ago. The questionnaire was designed specifically for the study and included questions on neuropathic symptoms. Responses were correlated with data from our prospectively entered database for analysis. Results: Nine hundred and forty-eight people were included in the study, of which 600 responded (63%). Prevalence of chronic pain is 57% at 7–12 months, 36% at 4–5 years and 21% at 6–7 years. Patient age, consultant and time since the operation all have significant effects. Surgical approach (video-assisted thoracoscopic surgery, thoracotomy) and diagnosis are not significant. Thirty-nine percent of those with pain take analgesia, 46% felt their pain is their worst medical problem and 40% reported it limits their daily activities. The prevalence of each neuropathic symptom is between 35 and 83%. The presence of a neuropathic symptom is associated with significantly more severe pain, more analgesia use and pain more likely to limit daily activity. Conclusions: Chronic pain has a significant prevalence and impact on patients’ lives for several years after thoracic surgery. Nerve dysfunction is associated with more severe pain, a greater impact and tends to persist. The reason for the individual consultant being an important factor in post-thoracotomy pain needs further investigation.

Key Words: Chronic pain • Neuropathic pain • Thoracotomy • VATS

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