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

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 36; no. 2; pp. 500 - 509
• Main Authors: Laurent, Quentin, Michel-Cherqui, Mireille, Szekely, Barbara, Glorion, Matthieu, Sage, Édouard, Trichereau, Julie, Fischler, Marc, Fessler, Julien, Guen, Morgan Le
• Format: Journal Article
• Language: English
• Published: WB Saunders 2022
• Subjects: Humanities and Social Sciences; Life Sciences; pain; cystic fibrosis; lung transplantation; cystic fibrosis, lung transplantation, pain, quality of life, lung transplantation pain cystic fibrosis quality of life, cystic fibrosis; quality of life
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2021.07.041

Objective: 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. Design: A prospective cohort study. Setting: The Foch University Hospital, Suresnes, France. Participants: Patients registered on the waiting list for double-lung transplantation in the authors’ institution from August 2008 to October 2013 and transplanted. Interventions: Database prospectively completed in real time during consultations with a pain-certified anesthesiologist before lung transplantation and six months after surgery. Measurements and Main Results: 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). Conclusions: 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.