• Christopher W Liu, M Gabrielle Page, Aliza Weinrib, Dorothy Wong, Alexander Huang, Karen McRae, Joseph Fiorellino, Diana Tamir, Michael Kahn, Rita Katznelson, Karim Ladha, Faraj Abdallah, Marcelo Cypel, Kazuhiro Yasufuku, Vincent Chan, Monica Parry, James Khan, Joel Katz, and Hance Clarke.
• Department of Pain Medicine, Singapore General Hospital, Outram, Singapore.
• J Anesth. 2021 Aug 1; 35 (4): 505-514.

PurposeChronic post-surgical pain (CPSP) is a highly prevalent complication following thoracic surgery. This is a prospective cohort study that aims to describe the pain trajectories of patients undergoing thoracic surgery beginning preoperatively and up to 1 year after surgery METHODS: Two hundred and seventy nine patients undergoing elective thoracic surgery were enrolled. Participants filled out a preoperative questionnaire containing questions about their sociodemographic information, comorbidities as well as several psychological and pain-related statuses. They were then followed-up during their immediate postoperative period and at the three, six and 12 month time-points to track their postoperative pain, complications and pain-related outcomes. Growth mixture modeling was used to construct pain trajectories.ResultsThe first trajectory is characterized by 185 patients (78.1%) with mild pain intensity across the 12 month period. The second is characterized by 32 patients (7.5%) with moderate pain intensity immediately after surgery which decreases markedly by 3 months and remains low at the 12 month follow-up. The final trajectory is characterized by 20 patients (8.4%) with moderate pain intensity immediately after surgery which persists at 12 months. Patients with moderate to severe postoperative pain intensity were much more likely to develop CPSP compared to patients with mild pain intensity. Initial pain intensity levels immediately following surgery as well as levels of pain catastrophizing at baseline were predicting pain trajectory membership. None of the surgical or anesthetic-related variables were significantly associated with pain trajectory membership.ConclusionPatients who undergo thoracic surgery can have postoperative pain that follows one of the three different types of trajectories. Higher levels of immediate postoperative pain and preoperative pain catastrophizing were associated with moderately severe CPSP.© 2021. Japanese Society of Anesthesiologists.

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