Acupuncture as a Therapeutic Approach to Postthoracotomy Pain

Abstract

Abstract

Background:

Chronic postthoracotomy pain (CPP) is defined as an aching or burning sensation 2 months postoperatively along the incision site (lateral or posterior-lateral). Prevalence rates range from 44%–54%.

Objective:

To define, quantify, and review techniques to prevent and reduce the incidence of CPP.

Design and Setting:

A comprehensive literature review using OVIDMEDLINE and PUBMED was performed based on preoperative, perioperative, and postoperative techniques that have attempted to reduce the incidence of CPP. Treatment options consisted of preoperative epidural catheters, operative techniques, and postoperative cutaneous extrapleural intercostal nerve block, acupuncture, PCA pumps, gabapentin, or analgesics.

Main Outcome Measures:

Pain was measured using a visual analog scale (VAS), 4-point scale, McGill Pain Questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, verbal response scale, numerical rating scale, or a brief pain inventory scale.

Results:

To date, only gabapentin, transdermal nitroglycerin/etodolac, and acupuncture have produced modest reductions in pain. However, these studies were limited due to either size or length of follow-up.

Conclusions:

With a lack of definitive treatment options for CPP, and the ability to administer acupuncture to this population of patients, a trial should be conducted to address its efficacy.