Post-thoracotomy Pain

Post-thoracotomy pain syndrome (PTPS) is a musculoskeletal pain condition defined by the IASP as pain that recurs or persists along a thoracotomy incision at least two months following the surgical procedure and the pain must also not be related to metastasis or other treatments. The prevalence/incidence of PTPS varies greatly from 33% to 91%. The exact pathologic mechanism for developing PTPS is unknown and is still being investigated but is believed to be a combination of somatic, visceral, and neuropathic pain components, which are often complicated with central sensitization. Diagnostic criteria require a detailed medical history with temporal and clinical components. Treatment includes the development of new surgical techniques to prevent the development of PTPS, anesthetic techniques (e.g., SAPB, TEA), pharmacological treatment (e.g., gabapentin and pregabalin, NMDA antagonists), and interventional treatment (e.g., thermal radio frequency ablation, neuromodulation/nerve stimulation).