However , intercostal nerve injury seems to be the most important pathogenic factor .
Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25 - 60 % of patients .
Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre- , intra- , and postoperative factors .
This review attempts to analyse the methodology and systematic s of the studies on the  post-thoracotomy pain syndrome ( PTPS ) after lung cancer surgery in adults , in order to clarify the relative role of possible pathogenic factors and to define future strategies for prevention .
Prediction of Postoperative Pain by Preoperative Nociceptive Responses to Heat Stimulation
Background Despite major advances in the underst and ing of the neurobiologic mechanisms of pain , the wide variation in acute pain experience has not been well explained . Therefore , the authors investigated the potential of a preoperatively induced heat injury to predict subsequent postoperative pain ratings in patients undergoing knee surgery . Methods Twenty patients were studied . The burn injury was induced 6 days before surgery with a contact thermode ( 12.5 cm2 , 47 ° C for 7 min ) . The sensory testing , before and 1 h after the injury , included pain score during induction of the burn , secondary hyperalgesia area , thermal and mechanical pain perception , and pain thresholds . Postoperative analgesia consisted of ibuprofen and acetaminophen . Pain ratings ( visual analog scale ) at rest and during limb movement were followed for 10 days after surgery . Results The burn injury was associated with development of significant hyperalgesia . There was a significant correlation between preoperative pain ratings during the burn injury and early ( 0–2 days , area under the curve ) and late ( 3–10 days , area under the curve ) postoperative dynamic pain ratings during limb movement . Conclusion The results of this study suggest that the pain response to a preoperative heat injury may be useful in research in predicting the intensity of postoperative pain . These findings may have important implication s to identify patients at risk for development of chronic pain and to stratify individuals for investigations of new analgesics
However , intercostal nerve injury seems to be the most important pathogenic factor .
Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25 - 60 % of patients .
Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre- , intra- , and postoperative factors .
This review attempts to analyse the methodology and systematic s of the studies on the  post-thoracotomy pain syndrome ( PTPS ) after lung cancer surgery in adults , in order to clarify the relative role of possible pathogenic factors and to define future strategies for prevention .