Abstract
Chronic pain after surgery is surprisingly common. Chronic post-thoracotomy pain (CPTP) is a common sequela of chest surgery affecting as many as one half of patients. The pain of this condition may extend from the time of surgery or begin anew in the months after the procedure. Of those affected by CPTP more than one half will have neuropathic pain. CPTP has a significant impact on the daily lives of the patients. It impairs sleep and daily activity, and up to 40% of patients will continue to take an analgesic 2 years after the surgery. Less invasive surgical practices may reduce rates of CPTP although the rates CPTP after VATS are similar to those of traditional thoracotomy techniques. Less traumatic methods of opening and closing the chest have a significant impact on the rate of CPTP. Advances in novel treatments for neuroinflammation may someday play a role in control of pain after thoracotomy. Optimal prevention and treatment of CPTP may involve inter-professional and interdisciplinary management to identify risk factors, optimize surgical technique, and provide optimal anesthetic management, perioperative, and chronic pain interventions.
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