Early Postoperative Pain Trajectories after Posterolateral and Axillary Approaches to Thoracic Surgery: A Prospective Monocentric Observational Study

Less-invasive thoracotomies may reduce early postoperative pain. The aims of this study were to identify pain trajectories from postoperative days 0–5 after posterolateral and axillary thoracotomies and to identify potential factors related to the worst trajectory. Patients undergoing a posterolateral (92 patients) or axillary (89 patients) thoracotomy between July 2014 and November 2015 were analyzed in this prospective monocentric cohort study. The best-fitting model resulted in four pain trajectory groups: trajectory 1, the “worst”, with 29.8% of the patients with permanent significant pain; trajectory 2 with patients with low pain (32.6%); trajectory 3 with patients with a steep decrease in pain (22.7%); and trajectory 4 with patients with a steep increase (14.9%). According to a multinomial logistic model multivariable analysis, some predictive factors allow for differentiation between trajectory groups 1 and 2. Risk factors for permanent pain are the existence of preoperative pain (OR = 6.94, CI 95% (1.54–31.27)) and scar length (OR = 1.20 (1.05–1.38)). In contrast, ASA class III is a protective factor in group 1 (OR = 0.02 (0.001–0.52)). In conclusion, early postoperative pain can be characterized by four trajectories and preoperative pain is a major factor for the worst trajectory of early postoperative pain.

Mots clés

lung surgery pain thoracotomy trajectory

Domaines

Sciences du Vivant [q-bio] Sciences de l'Homme et Société

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jcm-11-05152.pdf (1.26 Mo)

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https://hal.science/hal-04348017

Soumis le : vendredi 15 décembre 2023-23:06:58

Dernière modification le : mardi 24 septembre 2024-15:34:04

Dates et versions

hal-04348017 , version 1 (15-12-2023)

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Paternité

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HAL Id : hal-04348017 , version 1
DOI : 10.3390/jcm11175152
PUBMED : 36079080
WOS : 000852539400001

Citer

Pascaline Dorges, Mireille Michel-Cherqui, Julien Fessler, Barbara Székély, Édouard Sage, et al.. Early Postoperative Pain Trajectories after Posterolateral and Axillary Approaches to Thoracic Surgery: A Prospective Monocentric Observational Study. Journal of Clinical Medicine, 2022, 11 (17), pp.5152. ⟨10.3390/jcm11175152⟩. ⟨hal-04348017⟩

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