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Chapter 30 - Post-thoracotomy Pain

from Part VI - Misc

Published online by Cambridge University Press:  01 December 2023

By
Zahaan Eswani  and
Jamal Hasoon
Edited by
Omar Viswanath  and
Ivan Urits
Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Post-thoracotomy pain syndrome (PTPS) is a musculoskeletal pain condition defined by the IASP as pain that recurs or persists along a thoracotomy incision at least two months following the surgical procedure and the pain must also not be related to metastasis or other treatments. The prevalence/incidence of PTPS varies greatly from 33% to 91%. The exact pathologic mechanism for developing PTPS is unknown and is still being investigated but is believed to be a combination of somatic, visceral, and neuropathic pain components, which are often complicated with central sensitization. Diagnostic criteria require a detailed medical history with temporal and clinical components. Treatment includes the development of new surgical techniques to prevent the development of PTPS, anesthetic techniques (e.g., SAPB, TEA), pharmacological treatment (e.g., gabapentin and pregabalin, NMDA antagonists), and interventional treatment (e.g., thermal radio frequency ablation, neuromodulation/nerve stimulation).

Keywords

thoracotomy painchest painPTPSthoracotomy incision painupper chest chronic pain
Type
Chapter
Information
Cambridge Handbook of Pain Medicine , pp. 240 - 247
Publisher: Cambridge University Press
Print publication year: 2023

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References

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