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

The Influence of Different Anesthesia and Postoperative Pain Management on Acute and Chronic Postsurgical Pain After Thoracic Surgery: a Prospective Study

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.

Study Overview

• Status: Unknown
• Conditions: Acute Pain; Chronic Postsurgical Pain
• Intervention / Treatment: Procedure: epidural anesthesia; Procedure: nerve block

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 Type: Observational
• Enrollment (Anticipated): 600

Contacts and Locations

• Study Contact: Name: shuwei wang; Phone Number: +8613564440601; Email: veronciawang228@126.com

Study Locations

• China
  • Shanghai
    • Shanghai, Shanghai, China, 200032
      • Recruiting
      • Zhongshan Hospital, Fudan University
      • Contact: Jing Cang, PhD; Phone Number: 2331 86-21-64041990; Email: cang.jing@zs-hospital.sh.cn
      • Principal Investigator: shuwei wang, MD
      • Sub-Investigator: min fei, MD
      • Sub-Investigator: Hong ZHANG

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients underwent selective thoracic surgery meeting inclusion and exclusion criteria

Description

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 Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Prospective

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
general anesthesia; patients underwent general anesthesia
general and epidural anesthesia; patients underwent general and epidural anesthesia	Procedure: epidural anesthesia; epidural anesthesia
general anesthesia combined with nerve block; patients underwent general anesthesia combined with nerve block	Procedure: nerve block; paravertebral or serratus anterior plane block

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
numerical rating scale of acute postsurgical pain	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.	at day1 post-operation
numerical rating scale of acute postsurgical pain	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.	at day2 post-operation
numerical rating scale of chronic postsurgical pain	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.	at 3rd month post-operation
numerical rating scale of chronic postsurgical pain	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.	at 6th month post-operation

Collaborators and Investigators

• Sponsor: Shanghai Zhongshan Hospital
• Investigators: Study Chair: jing cang, Shanghai Zhongshan Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2018
• Primary Completion (Anticipated): December 31, 2019
• Study Completion (Anticipated): July 30, 2020

Study Registration Dates

• First Submitted: February 10, 2019
• First Submitted That Met QC Criteria: February 18, 2019
• First Posted (Actual): February 20, 2019

Study Record Updates

• Last Update Posted (Actual): February 20, 2019
• Last Update Submitted That Met QC Criteria: February 18, 2019
• Last Verified: February 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Pain, Postoperative; Acute Pain; Physiological Effects of Drugs; Central Nervous System Depressants; Anesthetics
• Other Study ID Numbers: cpsp-revisited

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No