Prevalence, Characteristics and Preoperative Predictors of Chronic Pain After Double-Lung Transplantation: A Prospective Cohort Study

• Published in: Journal of cardiothoracic and vascular anesthesia 2022-02, Vol.36 (2), p.500-509
• Main Authors: Laurent, Quentin, Michel-Cherqui, Mireille, Szekely, Barbara, Glorion, Matthieu, Sage, Edouard, Trichereau, Julie, Fischler, Marc, Fessler, Julien, Guen, Morgan Le
• Format: Article
• Language: English
• Subjects: Chronic Pain - diagnosis; Chronic Pain - epidemiology; cystic fibrosis; Humans; Life Sciences; lung transplantation; Lung Transplantation - adverse effects; pain; Pain, Postoperative - diagnosis; Pain, Postoperative - epidemiology; Pain, Postoperative - etiology; Prevalence; Prospective Studies; Quality of Life
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2021.07.041

Data on chronic pain after lung transplantation are heterogeneous. This study prospectively explored the prevalence, characteristics, consequences, and preoperative predictors of pain in lung transplant recipients. A prospective cohort study. The Foch University Hospital, Suresnes, France. Patients registered on the waiting list for double-lung transplantation in the authors’ institution from August 2008 to October 2013 and transplanted. Database prospectively completed in real time during consultations with a pain-certified anesthesiologist before lung transplantation and six months after surgery. The assessments explored pain in three components: physical (intensity, location, neuropathic and sensory qualifications, treatments), mental (anxiety and depression), and quality of life. Seventy-two patients underwent all assessments. The prevalence of six-month postoperative pain was 68.0%. Among patients with pain, 83.3% reported mild average pain and 26.5% had neuropathic pain. All patients who responded to the questionnaire took analgesics frequently, but only 9.1% took opioids. Patients with pain reported higher levels of anxiety (p = 0.02) and depression (p = 0.01). Additionally, they presented with increased difficulty in ambulation (p = 0.03), work (p = 0.02), and sleep (p = 0.02). The maximum level of preoperative pain was an independent risk factor of six-month postoperative pain (p = 0.03). The authors report a high prevalence of chronic pain with concomitant psychosocial repercussions despite a reported mild intensity. Perioperative measures, such as personalized and detailed management plans, could improve patient satisfaction.