Occurrence,risk factors,and impact on quality of life of chronic post-surgical pain following radical lung cancer surgery
Objective This study aimed to investigate the occurrence,risk factors,and impact on quality of life(QoL)of chronic post-surgical pain(CPSP)after radical lung cancer surgery through a prospective cohort study.Methods Atotal of 2118 patients aged 18 to 65 years,with American Society of Anesthesiologists(ASA)classification Ⅰ to Ⅲ,who under-went radical lung cancer surgery at Henan Provincial Chest Hospital from March 2022 to March 2023 were enrolled in this study.Demographic information such as age,gender,body mass index(BMI),educational level,marital status,living sit-uation,occupational status,preoperative pain at the surgical site,comorbidities,surgical type,duration of surgery,and anesthesia method were recorded.The highest numerical rating scale(NRS)score within 2 days after surgery was also recorded.Follow-up assessments were performed at 3,6,and 12 months post-surgery to evaluate the occurrence of CPSP.Patients were divided into CPSP and non-CPSP groups based on the occurrence of CPSP.Multivariate logistic regression analysis was used to identify risk factors for CPSP,and QoL scores were assessed in both groups.Results All 2 118 patients completed the in-hospital survey.However,248 pa-tients were lost to follow-up at 12 months,resulting in a loss to follow-up rate of 11.7％.Ultimately,1 870 patients successfully completed the 12-month follow-up,with a follow-up success rate of 88.3％.The overall occurrence rate of CPSP was 33.3％,with 32.5％of patients experiencing CPSP between 3 and 6 months,20.7％between 6 and 12 months,and 46.8％with a duration of more than 12 months.Further analysis revealed that female gender,high preopera-tive anxiety and depression scores,preoperative pain at the surgical site,non-diabetes comorbidity,open-chest surger-y,non-combined use of PCIA and TPVB analgesia protocol,and high NRS scores within 14 days after surgery were inde-pendent risk factors for CPSP(P＜0.05).Compared with the non-CPSP group,the CPSP group had significantly lower QoL scores in terms of physical function,role-physical,bodily pain,vitality,social function,role-emotional domain,mental health,and general health(P＜0.05).Conclusion CPSP following radical lung cancer surgery has a high occur-rence rate and a long duration,significantly affecting patients'QoL.Female gender,high preoperative anxiety and depres-sion scores,preoperative pain at the surgical site,non-diabetes comorbidity,open-chestsurgery,non-combined use of PCIA and TPVB analgesia protocol,and high early postoperative pain scores are independent risk factors for CPSP.
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