• H Hamada, K Moriwaki, K Shiroyama, H Tanaka, M Kawamoto, and O Yuge.
• Department of Anesthesiology and Critical Care Medicine, Hiroshima University School of Medicine, Japan. s-daimao@ma4.seikyou.ne.jp
• Reg Anesth Pain Med. 2000 May 1; 25 (3): 302-5.

ObjectivePostthoracotomy pain syndrome is generally considered to be neuropathic pain due to intercostal nerve injury. However, nonneuropathic pain can also occur following thoracic surgery. We present a series of cases with postthoracotomy pain syndrome in which myofascial pain was thought to be a causative component of postthoracotomy pain syndrome.Case ReportTwenty-seven patients (17 men and 10 women) were treated with trigger point injections, intercostal nerve blocks, and/or epidural blocks. Clinical criteria were used to diagnose the myofascial pain. A visual analogue scale was used, and sensory disturbances were recorded before and after treatment. A trigger point in a taut muscular band within the scapular region, which we diagnosed as myofascial pain, was observed in 67% of the patients. The existence of this trigger point significantly increased the rate of success for the treatments.ConclusionsPostthoracotomy pain may result, at least in part, from a nonneuropathic origin (myofascial pain). It is recommended that each patient be examined in detail to determine whether there is a trigger point in a taut muscular band within the scapular region. If found, this point is suggested as a good area for anesthetic injection.

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