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Rodney J. Landreneau
Michael J. Mack
Stephen R. Hazelrigg
Keith Naunheim
Robert D. Dowling
Mitchell J. Magee
Robert J. Keenan
Peter F. Ferson
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J Thorac Cardiovasc Surg 1994;107:1079-1086
© 1994 Mosby, Inc.

GENERAL THORACIC SURGERY

Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery

Rodney J. Landreneau, MDa, Michael J. Mack, MDb, Stephen R. Hazelrigg, MDc, Keith Naunheim, MDd, Robert D. Dowling, MDa, Pamela Ritter, RNa, Mitchell J. Magee, MDa, Susan Nunchuck, PhDc, Robert J. Keenan, MDa, Peter F. Ferson, MDa


Pittsburgh, Pa., Dallas, Tex., Milwaukee, Wis., and St. Louis, Mo.

Address for reprints: Rodney J. Landreneau, MD, Head, Section of Thoracic Surgery, University of Pittsburgh, Suite 811, Liliane Kaufmann Building, 3471 Fifth Ave., Pittsburgh, PA 15213.

Abstract

The prevalence and severity of chronic pain after video-assisted thoracic surgery for pulmonary resection remains to be defined. Three hundred forty-three of 391 consecutive patients 3 to 31 months after pulmonary resection by lateral thoracotomy (n = 165) or video-assisted thoracic surgery (n = 178) responded to a questionnaire aimed at comparing the relative occurrence of chronic postoperative pain after video-assisted thoracic surgery and lateral thoracotomy approaches for pulmonary resection. Patients less than 1 year after operation (video-assisted thoracic surgery = 142; thoracotomy = 97) and more than 1 year after operation (video-assisted thoracic surgery = 36; thoracotomy = 68) were analyzed as individual cohorts. Chronic pain was assessed by questioning patients about the presence and the intensity of discomfort on the side of the operation (using a visual analog scale) and their need for analgesic medication and the presence of ongoing limitations in shoulder function. Patients who underwent video-assisted thoracic surgery (less than 1 year from operation) had less pain and subjective shoulder dysfunction although their pain medication requirements were similar to those of thoracotomy patients less than 1 year from operation. After 1 year, there was no significant difference in these "pain related" morbidity parameters between the two surgical approach groups (video-assisted thoracic surgery or thoracotomy). (J THORACCARDIOVASCSURG1994;107:1079-86)




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