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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Acute Pain, Chronic Postsurgical Pain

Intervention / Treatment
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* Procedure: epidural anesthesia
* Procedure: nerve block


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 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 |
| --- | --- |
| general anesthesia<br>patients underwent general anesthesia | |
| general and epidural anesthesia<br>patients underwent general and epidural anesthesia | Procedure: epidural anesthesia<br>* epidural anesthesia<br>|
| general anesthesia combined with nerve block<br>patients underwent general anesthesia combined with nerve block | Procedure: nerve block<br>* paravertebral or serratus anterior plane block<br>|

What is the study measuring?
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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 |