The Influence of Different Anesthesia on Acute and Chronic Postsurgical Pain After Thoracic Surgery

• Conditions: Acute Pain; Chronic Postsurgical Pain
• Interventions: Procedure: epidural anesthesia; Procedure: nerve block

• Registration Number: NCT03847363
• Lead Sponsor: Shanghai Zhongshan Hospital

Brief Summary

This study would compare acute and chronic postsurgical pain in patients underwent thoracic surgery with different anesthesia and analgesia methods, and explore the influencing factors.

Detailed Description

Chronic postsurgical pain (CPSP) was the pain caused by the operation that exceeded the healing time of normal tissue (usually 3 months), that was, a status that the damage caused by noxious stimulus had been healed, but the pain that cannot be explained by disease and inflammation were still existed. Due to the location of the incision and the necessity of indwelling the chest tube, the thoracic lung surgery was considered to be one of the most painful surgical operations. Studies have found that the incidences of CPSP in patients with thoracotomy were 57% (95% CI, 51-64%) and 47% (95% CI, 39-56%) at postoperative 3 and 6 months, respectively. With the development of minimally invasive techniques, thoracic surgery had gradually become less traumatic, and the number of surgical incisions was gradually developed into single port.Through ages, epidural analgesia with a combination of local anesthetics and opioids had long been considered the "gold standard" for postoperative analgesia in thoracic surgery. However, with the development of clinical anesthetics and the widespread use of nerve block techniques, it had been found that in open radical gastrectomy, there was no significant difference in the inhibition of intraoperative stress response between dexmedetomidine combined with general anesthesia and a combined general-epidural anesthesia. So, which anesthesia and analgesia method was "perfect" for a specific type of surgery procedure? This study would compare acute and chronic postsurgical pain in patients underwent different thoracic surgery procedure with different anesthesia and analgesia methods, and explore the influencing factors.

Study Timeline

• Study Start: 2018-04-01
• Status Verified: 2019-02
• Study First Submitted: 2019-02-10
• Study First Submitted QC: 2019-02-18
• Last Update Submitted: 2019-02-18
• Study First Posted: 2019-02-20
• Last Update Posted: 2019-02-20
• Primary Completion: 2019-12-31
• Study Completion: 2020-07-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 600

Inclusion Criteria

• ASA I-II
• underwent selective thoracic surgery

Exclusion Criteria

• with severe cardiac, endocrine,immunologic or haematologic diseases
• medical history of chronic pain problems in chest area
• medical history of pain-relief or sedative medication
• not able to communicate with investigators

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
general and epidural anesthesia	epidural anesthesia	patients underwent general and epidural anesthesia
general anesthesia combined with nerve block	nerve block	patients underwent general anesthesia combined with nerve block

Primary Outcome Measures

Name	Time	Method
numerical rating scale of acute postsurgical pain	at day2 post-operation	numerical rating scale is a 11-point scale for patient self-reporting of pain, in which 0 stands for no pain and 10 stands for the most severe pain.
numerical rating scale of chronic postsurgical pain	at 6th month post-operation	numerical rating scale is a 11-point scale for patient self-reporting of pain, in which 0 stands for no pain and 10 stands for the most severe pain.

Trial Locations

Locations (1)

Zhongshan Hospital, Fudan University; 🇨🇳 Shanghai, Shanghai, China