Prediction of Chronic Pain by the Pain Monitor

Study Overview
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Brief Summary
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The skin conductance algesimeter (Pain Monitor™, Med-Storm Innovation AS, NO-0264 Oslo, Norway)) reflects the sympathetic nervous system by the measurement of the skin conductance of the palm of the hand. SCA detects nociceptive pain fast and continuously, specific to the individual, with higher sensitivity and specificity than other available objective methods. The skin conductance response to a calibrated noxious stimulus varies among patients. It defines two types of people depending on its magnitude. The investigators assume that the importance of skin conductance response to a noxious stimulus predicts the occurrence of chronic pain in patients operated by thoracotomy.

Official Title
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Prediction of the Occurrence of Chronic Pain After Thoracotomy by Measuring Preoperative Skin Conductance (Pain Monitor Device)

Conditions
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Surgery

Intervention / Treatment
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* Device: Pain Monitor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult patients of both sexes planned pulmonary resection for cancer performed by a posterolateral thoracotomy thoracic epidural analgesia Exclusion Criteria: pregnancy, morbid obesity, insulin-dependent diabetes with dysautonomia, inability to proceed with anesthesia using the BIS signal, known allergy to remifentanil, propofol, atracurium or to levobupivacaine, contra-indication to nefopam contra-indication to ketoprofen

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Thoracotomized patients<br> | Device: Pain Monitor<br>* Measurement of cutaneous conductance<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prediction of chronic pain | Prediction of chronic pain by the measurement of skin conductance | one year after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prediction of the postoperative pain | Prediction of the postoperative pain by the measurement of skin conductance. Postoperative pain is assessed (pain score) at least twice each day at rest and during mobilisation. | 5 days postoperatively | 
| Prediction of the postoperative antalgic requirement | Prediction of the postoperative analgesic requirement by the measurement of skin conductance. The analgesic requirement is evaluated by the amount of epidural analgesics. | 5 days postoperatively | 
| Prediction of the postoperative antalgic requirement by the genetic study | Prediction of the postoperative antalgic requirement by the genetic study | One year after surgery | 
| Effect of remifentanil on skin conductance | Skin conductance is measured before and after a calibrated noxious stimulus. This test is performed after the induction of anesthesia (propofol) and a first time before remifentanil administration and a second time after. | One hour after anesthesia |