• James S Khan, Elad Dana, Maggie Z X Xiao, Vivek Rao, George Djaiani, Ze'ev Seltzer, Karim Ladha, Alexander Huang, Karen McRae, Marcelo Cypel, Joel Katz, Dorothy Wong, and Hance Clarke.
• Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: james.khan@medportal.ca.
• J. Cardiothorac. Vasc. Anesth. 2024 Feb 1; 38 (2): 490498490-498.

ObjectiveThoracic surgery is associated with one of the highest rates of chronic postsurgical pain (CPSP) among all surgical subtypes. Chronic postsurgical pain carries significant medical, psychological, and economic consequences, and further interventions are needed to prevent its development. This study aimed to determine the prevalence, characteristics, and risk factors associated with CPSP after thoracic surgery.DesignA prospective cohort study.SettingSingle-center tertiary care hospital.ParticipantsThis study included 285 adult patients who underwent thoracic surgery at Toronto General Hospital in Toronto, Canada, between 2012 and 2020.Measurements And Main ResultsDemographic, psychological, and clinical data were collected perioperatively, and follow-up evaluations were administered at 3, 6, and 12 months after surgery to assess CPSP. Chronic postsurgical pain was reported in 32.4%, 25.4%, and 18.2% of patients at 3, 6, and 12 months postoperatively, respectively. Average CPSP pain intensity was rated to be 3.37 (SD 1.82) at 3 months. Features of neuropathic pain were present in 48.7% of patients with CPSP at 3 months and 71% at 1 year. Multivariate logistic regression models indicated that independent predictors for CPSP at 3 months were scores on the Hospital Anxiety and Depression Scale (adjusted odds ratio [aOR] of 1.07, 95% CI of 1.02 to 1.14, p = 0.012) and acute postoperative pain (aOR of 2.75, 95% CI of 1.19 to 6.36, p = 0.018).InterventionsNone.ConclusionsApproximately 1 in 3 patients will continue to have pain at 3 months after surgery, with a large proportion reporting neuropathic features. Risk factors for pain at 3 months may include preoperative anxiety and depression and acute postoperative pain.Copyright © 2023 Elsevier Inc. All rights reserved.

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