Kim Wildgaard1, Martin Iversen, Henrik Kehlet. 1. Department of Cardiothoracic Anesthesia double daggerDivision of Lung Transplantation, Heart Center Section for Surgical Pathophysiology, Rigshospitalet, University of Copenhagen, Denmark. wildgaard@thoracotomy.eu
Abstract
OBJECTIVES: Little is known about persistent postsurgical pain after lung transplantation with the associated intensive and continuous immunosuppressive treatment. Therefore, we investigated the nationwide incidence of chronic pain after lung transplantations. METHODS: Detailed questionnaires were sent to all 110 Danish surviving recipients of lung transplantation from September 2002 to September 2007. RESULTS: Seventy-nine patients fulfilled the inclusion criteria with a mean follow-up time of 39 months. Excluded patients were 1 death during survey, 14 with previous thoracic surgery, and 16 patients who did not respond to an initial mailed questionnaire or a reminder. Fourteen patients (18%) reported persistent pain, whereas only 8 patients (10%) reported pain score >3 (numeric rating scale 0 to 10) and 4 patients (5%) >5 (numeric rating scale 0 to 10). Seventy-one percent of the patients with postsurgical pain also had pain from another part of the body. In patients with persistent postsurgical pain, this was a limiting factor for daily social activities in 29% to 92% dependent on the activity and 54% in pain felt quality of life was compromised due to the pain. Seventy-three percent of persistent postsurgical pain patients (lateral thoracotomy) experienced sensory disturbances compared with 46% of nonpain patients. DISCUSSION: Moderate-to-severe persistent postsurgical pain occurred in 5% to 10% of patients after lung transplantation, which is lower than reported after nontransplant thoracotomy. The specific role of the peritransplant immunosuppression on persistent post-thoracotomy pain should be explored further.
OBJECTIVES: Little is known about persistent postsurgical pain after lung transplantation with the associated intensive and continuous immunosuppressive treatment. Therefore, we investigated the nationwide incidence of chronic pain after lung transplantations. METHODS: Detailed questionnaires were sent to all 110 Danish surviving recipients of lung transplantation from September 2002 to September 2007. RESULTS: Seventy-nine patients fulfilled the inclusion criteria with a mean follow-up time of 39 months. Excluded patients were 1 death during survey, 14 with previous thoracic surgery, and 16 patients who did not respond to an initial mailed questionnaire or a reminder. Fourteen patients (18%) reported persistent pain, whereas only 8 patients (10%) reported pain score >3 (numeric rating scale 0 to 10) and 4 patients (5%) >5 (numeric rating scale 0 to 10). Seventy-one percent of the patients with postsurgical pain also had pain from another part of the body. In patients with persistent postsurgical pain, this was a limiting factor for daily social activities in 29% to 92% dependent on the activity and 54% in pain felt quality of life was compromised due to the pain. Seventy-three percent of persistent postsurgical painpatients (lateral thoracotomy) experienced sensory disturbances compared with 46% of nonpain patients. DISCUSSION: Moderate-to-severe persistent postsurgical pain occurred in 5% to 10% of patients after lung transplantation, which is lower than reported after nontransplant thoracotomy. The specific role of the peritransplant immunosuppression on persistent post-thoracotomy pain should be explored further.
Authors: Emily M Rosenberger; Mary Amanda Dew; Andrea F DiMartini; Annette J DeVito Dabbs; Roger D Yusen Journal: Thorac Surg Clin Date: 2012-11 Impact factor: 1.750