Surgical aspects of chronic post-thoracotomy pain

Chronic post-thoracotomy pain is a continuous dysaesthetic burning and achi ng in the general area of the incision that persists at least 2 months afte r thoracotomy. It occurs in approximately 50% of patients after thoracotomy and is usually mild or moderate. However, in 5% the pain is severe and dis abling. No one technique of thoracotomy has been shown to reduce the incide nce of chronic postthoracotomy pain. The most likely cause is intercostal n erve damage, although the precise mechanism for this is not known. Future w ork needs to examine surgical technique in detail. Until then, patients nee d to be adequately warned of this sequela of thoracotomy. (C) 2000 Elsevier Science B.V. All rights reserved.