Post-Thoracotomy Pain: Current Strategies for Prevention and Treatment.

Journal Article (Journal Article;Review)

Treating acute pain after thoracotomy surgery and preventing the development of chronic post-thoracotomy pain syndrome (PTPS) remain significant challenges in this surgical population. While appropriately treated acute thoracotomy pain often resolves, a significant number of patients develop PTPS, with up to 65% of patients experiencing some pain and 10% suffering life-altering, debilitating pain. Currently, there is very little known about specific molecular targets or novel therapeutic combinations that effectively prevent PTPS. Identifying modifiable clinical risk factors (procedure, physical and mental health, preoperative pain in the surgical area and another regions) seems to the most pragmatic approach for prevention for now. Effective acute pain management adopting a multimodal approach can result in a decreased incidence of PTPS. Interventional techniques such as paraverterbral blocks, intercostal blocks, and erector spinae blocks show some promise as well. Future research should be focused on minimally invasive surgeries and also the effect of ERAS protocols, including early mobilization, nutrition, and early removal of drains, on the development of PTPS.

Full Text

Duke Authors

Cited Authors

  • Gupta, R; Van de Ven, T; Pyati, S

Published Date

  • November 2020

Published In

Volume / Issue

  • 80 / 16

Start / End Page

  • 1677 - 1684

PubMed ID

  • 32876936

Electronic International Standard Serial Number (EISSN)

  • 1179-1950

Digital Object Identifier (DOI)

  • 10.1007/s40265-020-01390-0

Language

  • eng

Conference Location

  • New Zealand