Clinical trial NCT05379816: Persistent Pain Induced by Uniportal Video-assisted Thoracic Surgery
Official title: A Prospective Study of Persistent Pain Induced by Uniportal Video-assisted Thoracic Surgery: Incidence, Diagnosis, and Intercostal Nerve Treatment
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Post-thoracotomy Pain Syndrome
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2022-05-18
Enrollment: 70
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Conservative management indicates medication treatment. Interventional treatment indicate injection treatment
Primary purpose: TREATMENT

Brief summary: The investigators investigate the prevalence of PTPS in patients receiving with uniportal video-assisted thoracic surgery (VATS), and early identify neuropathic pain as well as treated with neural protective strategy to target intercostal nerve.

Detailed description: More than 30% of patients have persistent pain after thoracic surgery. Intercostal neuralgia is characterized by neuropathic pain in the distribution of affected intercostal nerve(s) (along the ribs, chest, or abdomen) that commonly manifests as a sharp, aching, radiating, burning, or stabbing pain and may be associated with paresthesia such as numbness and tingling. The pain may be intermittent or constant and typically presents as a band-like pain that is wrapped around the chest and back or in a thoracic dermatomal pattern. Pain may last for a prolonged period and may continue long after the disease process has subsided.

Hypertonic dextrose injection (prolotherapy) is reported to reduce pain, including non-surgical chronic low back pain (CLBP), and subcutaneous injection of 5% dextrose is said to minimize neurogenic pain hyperalgesia and allodynia. The mechanism in both cases is unclear, though a direct effect of dextrose on neurogenic pain has been proposed. This study assessed the short-term analgesic effects of epidural 5% dextrose injection compared with saline for non-surgical CLBP.

Intercostal nerve damage is a suspected pathogenic mechanism for developing post-thoracotomy pain syndrome (PTPS). Video-assisted thoracic surgery (VATS) is a minimally invasive procedure that potentially reduces PTPS. However, there was no specific outcome study for uniportal VATS.

In this study, the investigators investigate the prevalence of PTPS in patients receiving uniportal video-assisted thoracic surgery (VATS), identify neuropathic pain early, and treat it with a neural protective strategy to target intercostal pain nerve.

Eligibility criteria: Inclusion Criteria:

* PTPS after single port VATS

Exclusion Criteria:

* abnormal sensation
* can not complete questionnaire
* others cause of pain

Primary outcomes:
measure: Pain score
timeFrame: 3 months
Secondary outcomes:
measure: Quantitative sensory test
timeFrame: 3 months
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National taiwan university cancer center
Study officials:
affiliation: National Taiwan University Cancer Center
name: Wen-ying Lin, Dr.
role: PRINCIPAL_INVESTIGATOR
References: