Post-Thoracotomy Pain in Children and Adolescence: A Retrospective Cross-Sectional Study

Abstract

Objective: We sought to determine the prevalence of chronic post-thoracotomy pain, defined as persistent or recurring incisional pain for at least 2 months after thoracotomy, in children. Design: Retrospective cross-sectional study. Setting: Quaternary pediatric teaching hospital. Subjects: Patients who underwent a lateral thoracotomy from January 2005 to December 2007 at the Royal Children's Hospital, Melbourne, Australia. Methods: Eligible patients were sent a questionnaire for telephonic completion with a researcher, with assistance from the parents if required. Results: Of the 87 patients eligible to participate, 51 (59%) completed questionnaires. The majority of respondents was male (65%), underwent a single thoracotomy (84%; range 1-3), and were non-elective operations (71%). The median age at first thoracotomy was 5.7 (interquartile range [IQR] 2-14.2) years. The median age at questionnaire completion was 9.0 (IQR 5.4-17.9) years, with 3.6 (IQR 2.8-4.1) years between thoracotomy and time of questionnaire completion. Three patients (6%) scored ≥12 on self-report versions of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Of these, only one patient complained of current post-thoracotomy pain. All three patients had a single thoracotomy and were older (mean age 14.2 years) at the time of thoracotomy. The rate of post-thoracotomy pain calculated using the binomial exact method is 1.96% (95% confidence interval 0-10.4%). Conclusions: Our study reports a low prevalence of post-thoracotomy pain in childhood and adolescence, and stands in contrast to previously published adult data. © 2014 American Academy of Pain Medicine Wiley Periodicals, Inc.