Abstract
BackgroundThoracic surgery appears to be the treatment of choice for many lung cancers. Nevertheless, depending on the type of surgery, the chest area may be painful for several weeks to months after surgery. This painful state has multiple physical and psychological implications, including respiratory failure, inability to clear secretions by coughing, and even anxiety and depression that have negative effects on recovery.ObjectiveThe aim of this study is to evaluate the effect of a neurofeedback-based intervention on controlling acute post-surgery pain and improving long-term recovery in patients who undergo thoracotomy for lung resection for non-small cell lung cancer (NSCLC) at an academic oncologic hospital.MethodsThis study will be based on a 2-parallel group randomized controlled trial design, intervention versus usual care, with multiple in-hospital assessments and 2 clinical, radiological, and quality of life follow-ups. Participants will be randomized to either the intervention group receiving a neurofeedback-based relaxation training and usual care, or to a control group receiving only usual care. Pain intensity is the primary outcome and will be assessed using the Numeric Pain Rating Scale (NRS) in the days following the operation. Secondary outcomes will include the effect of the intervention on hospital utilization for pain crisis, daily opioid consumption, anxiety, patient engagement, blood test and chest x-ray results, and long-term clinical, radiological, and quality of life evaluations. Outcome measures will be repeatedly taken during hospitalization, while follow-up assessments will coincide with the follow-up visits. Pain intensity will be assessed by mixed model repeated analysis. Effect sizes will be calculated as mean group differences with standard deviations.ResultsWe expect to have results for this study before the end of 2016.ConclusionsThe proposed innovative, neurofeedback- and relaxation-based approach to support post-surgery pain management could lead to significant improvements in patient short and long-term outcomes.
Highlights
BackgroundLung cancer has been the most common cancer worldwide since 1985, both in terms of incidence and mortality [1,2,3], and it is among the top five most frequently diagnosed cancers in Italy [4]
Distraction, and new technologies have beneficial effects on pain reduction, we propose to implement a research protocol that, by merging these factors, could help post-operative lung cancer patients to cope with acute pain generated by surgery
A prompt reduction of pain is fundamental to reduce the risk of respiratory failure and/or the inability to clear secretions by coughing, as well as the probability to develop long-term negative physical and psychological conditions that can significantly interfere with a full recovery
Summary
Lung cancer has been the most common cancer worldwide since 1985, both in terms of incidence and mortality [1,2,3], and it is among the top five most frequently diagnosed cancers in Italy [4]. Several studies have demonstrated the effectiveness of non-pharmacological techniques (eg, relaxation) that, in addition to traditional treatments, are able to significantly reduce the acute pain and distress associated with invasive medical procedures [21,22]. Syrjala et al [28] conducted a study to evaluate the effectiveness of cognitive-behavioral techniques and relaxation in reducing cancer-related pain and found that patients who received these type of treatments, in addition to medical care, reported less pain than the control groups. Distraction, and new technologies have beneficial effects on pain reduction, we propose to implement a research protocol that, by merging these factors, could help post-operative lung cancer patients to cope with acute pain generated by surgery. Long-term outcomes include clinical, radiological, and quality of life evaluations at the 1 and 4 month follow-ups
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