Prevalence and Characteristics of Persistent Postoperative Pain After Thoracic Surgery

AUTHORS: Wang, Lu MD, PhD et al

Anesthesia & Analgesia 137(1):p 48-57, July 2023

BACKGROUND:

A systematic review and meta-analysis was conducted to investigate the prevalence and characteristics of persistent (≥3 months) postoperative pain (PPP) after thoracic surgery.

METHODS:

For this purpose, Medline, Embase, and CINAHL databases were searched for the prevalence and characteristics of PPP after thoracic surgery from their inception to May 1, 2022. Random-effect meta-analysis was used to estimate pooled prevalence and characteristics.

RESULTS:

We included 90 studies with 19,001 patients. At a median follow-up of 12 months, the pooled overall prevalence of PPP after thoracic surgery was 38.1% (95% confidence interval [CI], 34.1–42.3). Among patients with PPP, 40.6% (95% CI, 34.4–47.2) and 10.1% (95% CI, 6.8–14.8) experienced moderate-to-severe (rating scale ≥4/10) and severe (rating scale ≥7/10) PPP, respectively. Overall, 56.5% (95% CI, 44.3–67.9) of patients with PPP required opioid analgesic use, and 33.0% (95% CI, 22.5–44.3) showed a neuropathic component.

CONCLUSIONS:

One in 3 thoracic surgery patients developed PPP. There is a need for adequate pain treatment and follow-up in patients undergoing thoracic surgery.

KEY POINTS

  • Question: What is the global prevalence of persistent postoperative pain (PPP) after thoracic surgeries and its characteristics?
  • Findings: Approximately 38.0% of thoracic surgery patients experience PPP and most of them experience moderate-to-severe PPP.
  • Meaning: There is a need for adequate pain treatment and follow-up in patients undergoing thoracic surgery.

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