Acute and Chronic Pain After Video-assisted Thoracoscopic Surgery for Lung Cancer

Acute and Chronic Pain After Video-assisted Thoracoscopic Surgery for Lung Cancer in Patients With Preoperative CT-guided Hookwire Localization

The aim of this study is to evaluate whether preoperative CT- guided hookwire localization would influence the incidence and intensity of acute and chronic pain after VATS.

Study Overview

• Status: Completed
• Conditions: Lung Cancer
• Intervention / Treatment: Other: Hookwire localization

Detailed Description

Postoperative pain after thoracic surgery has gained recognition as a adverse outcome and head-scratching problem. The incidence of choric postoperative pain (CPSP) in thoracic surgery has been reported to be 20%-80%. However, there has been not an standard treatment for CPSP. Many study has showed the risk factors of CPSP in thoracic surgery, such as VATS type, operation time, duration of drainage, preoperative pain, repeat surgery, gender, postoperative chemotherapy or radiation therapy , etc. It is important that moderate-to-severe acute postoperative pain will be transformed into CPSP. That offers a new management goal in postoperative pain prevention.CT-guided hookwire localization have been proven to be benefical for VATS to diagnose and treat small pulmonary , it can shorten operation timing and increase surgery success rate. However, it causes roughly 23.8% severe pain and complaints included wire dislodgement, pneumothorax and haemorrhage during and after insertion. The question is whether or not the moderate-to-severe acute postoperative pain from hookwire localition will change the incidence and intensity of CPSP in VATS.

Nurses play a pivotal role in advanced practice, research, and education in the field of pain management. The pain management of hookwire localization may be a new vison in further research.

• Study Type: Observational
• Enrollment (Actual): 161

Contacts and Locations

Study Locations

• China
  • Shanghai, China, 200032
    • 270 Dongan Road, Fudan University Shanghai Cancer Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

The institutional review board approved this prospective study. This study included 138 consecutive patients who underwent CT-guided localization before VATS , of which 69 using hookwire (Group A) and 69 without hookwire (Group B). The inclusion criteria were as follows: patients were planned to underwent VATS for lung cancer .

Description

Inclusion Criteria:

• Aged 18-75
• patients who underwent underwent CT-guided localization before VATS
• ASA I-II
• BMI 18.5-30
• no serious complications after localization
• sign informed consent

Exclusion Criteria:

• could not complish underwent CT-guided localization
• selfexpression or visual dysfunction
• having emergency surgery
• a severe psychiatric illness
• having chronic pain problems in the chest area
• Pregnant women

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Group A; Before operation,patients were performed CT -guided hook wire localization(20G×120mm, PAJUNK medizintechnologie, Geisingen in Germany). patients were placed on a CT table in a suitable position(supine, prone, lateral) to obtain the shortest needle insertion route for their initial CT scan. Local anesthesia of the skin and planned puncture tract was performed using 10ml Lidocaine 1%. Next, the needle was inserted into or near the pulmonary nodule.	Other: Hookwire localization; Patients were performed CT -guided hook wire localization(20G×120mm, PAJUNK medizintechnologie, Geisingen in Germany). patients were placed on a CT table in a suitable position(supine, prone, lateral) to obtain the shortest needle insertion route for their initial CT scan. Local anesthesia of the skin and planned puncture tract was performed using 10ml Lidocaine 1%. Next, the needle was inserted into or near the pulmonary nodule.
Group B; without hookwire localization

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
postoperative incidence and intensity of chronic pain after surgery	the incidence and severity（11-point numerical rating scale,0=painless, 10=woest pain）of pain was assessed after VATS operation	at postoperative 3rd month
postoperative incidence and intensity of chronic pain after surgery	the incidence and severity（11-point numerical rating scale, 0=painless, 10=worst pain）of pain was assessed after VATS operation	at postoperative 6th month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
postoperative length of stay in hospital	the days between postoperative 1st day and day of discharge from hospital	an average of 1 week
satisfactory score	Likert score (from 1 to 5),higher scores mean a better outcome	from the day discharge from hospital to postoperative 6th month
intensity of postoperative acute pain	the severity(11-point numerical rating scale, 0=no pain, 10=worst pain) after VATS operation	from immediately after surgery(at postanesthesia care unit ) to postoperative 2nd day

Collaborators and Investigators

• Sponsor: Fudan University
• Investigators: Principal Investigator: Jun Zhang, PhD, Department of Anesthesiology, Fudan University Shanghai Cancer Center

Study record dates

Study Major Dates

• Study Start (Actual): August 10, 2021
• Primary Completion (Actual): July 21, 2022
• Study Completion (Actual): July 21, 2022

Study Registration Dates

• First Submitted: May 30, 2022
• First Submitted That Met QC Criteria: July 25, 2022
• First Posted (Actual): July 28, 2022

Study Record Updates

• Last Update Posted (Actual): October 24, 2022
• Last Update Submitted That Met QC Criteria: October 21, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: Lung cancer; Video-assisted Thoracoscopic Surgery; hookwire location
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Neoplasms; Lung Diseases; Neoplasms by Site; Pain; Neurologic Manifestations; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Neoplasms; Chronic Pain
• Other Study ID Numbers: pain assessment after VATS

Drug and device information, study documents

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