The following is a summary of “Preoperative susceptibility to developing secondary hyperalgesia is associated with post-thoracotomy pain at 2 months,” published in the December 2024 issue of Pain by Gousset et al.
Accurate identification of individuals at high risk for persistent postoperative pain is crucial for the effective implementation of targeted preventative strategies.
Researchers conducted a retrospective study to examine whether assessing an individual’s susceptibility to experimentally induced secondary hyperalgesia before surgery was linked to experiencing pain 2 months after thoracotomy.
They recruited 41 patients scheduled for posterolateral thoracotomy and followed them for 2 months. The day before surgery, secondary hyperalgesia was experimentally induced on 1 forearm, measuring changes in mechanical pinprick perception and the hyperalgesia area. On postoperative Day 4, 15, and at the 2-month follow-up, patients reported pain intensity at rest and during coughing. Additionally, the area of secondary hyperalgesia around the scar and changes in mechanical pinprick perception were measured.
The results showed that 20 of the 41 recruited patients were analyzed, with 40% reporting pain at the 2-month follow-up. All reported cough-evoked pain, and 10% also experienced pain at rest. A binary logistic regression model with the magnitude and extent of experimentally induced secondary hyperalgesia was significant (chi-squared = 12.439, P = 0.002, McFadden R2= 0.462) and demonstrated excellent discriminative power (AUC = 0.938) for the presence of cough-evoked pain at the 2-month follow-up.
Investigators concluded the individual susceptibility to experimentally induced secondary hyperalgesia prior to surgery might predict the development of persistent post-thoracotomy pain.
Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.4768
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