Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia.

Thoracotomy is one of the most painful surgical incisions. Little is known, however, about the effect of type of anaesthesia on chronic post-thoracotomy pain syndrome (CPTS). We therefore compared the incidence of CPTS after total intravenous anaesthesia (TIVA) and inhalation anaesthesia. Patients (n = 366) were prospectively randomized into two groups: Group I (n = 173) received TIVA (propofol + remifentanil) and Group II (n = 170) received inhalation anaesthesia with sevoflurane. We assessed acute pain on postoperative days 1, 3 and 5, and the prevalence of CPTS at 3 and 6 months using a numerical rating scale (NRS). The prevalence of CPTS was significantly lower in patients receiving TIVA than in those receiving inhalation anaesthesia at 3 months (38.2% versus 56.5%, P = 0.001) and at 6 months (33.5% versus 50.6%, P = 0.002), respectively. Moreover, allodynia-like pain was significantly less common in the TIVA group at 3 (P = 0.021) and 6 months (P = 0.032). NRS score of acute pain, however, did not differ significantly between the two groups. TIVA with propofol and remifentanil may reduce the incidence of CPTS at 3 and 6 months.

Citation

Jun-Gol Song, Jin Woo Shin, Eun Ho Lee, Dae Kee Choi, Ji Youn Bang, Ji Hyun Chin, In Cheol Choi. Incidence of post-thoracotomy pain: a comparison between total intravenous anaesthesia and inhalation anaesthesia. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2012 May;41(5):1078-82

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PMID: 22290901

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