Pain-related impairment in daily activities after lung cancer surgery: A 1-year prospective cohort study.

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-11-04 DOI:10.1002/ejp.4749
Allan V Danielsen, Jan J Andreasen, Birthe Dinesen, John Hansen, Kristian K Petersen, Kirsten S Duch, Carsten Simonsen, Lars Arendt-Nielsen
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Abstract

Background: Persistent postsurgical pain (PPSP) following thoracic surgery affects 40%-60% of patients undergoing lung resection due to malignancies. Postoperative pain-related symptoms are common, leading to limitations in activities of daily living (ADL) and deterioration in physical function, which significantly impacts quality of life. Pain-related limitations are of interest, as postsurgical pain may present as a target for intervention to improve postoperative rehabilitation. This study aimed to evaluate the association between PPSP and ADL limitations during the first 12 postoperative months after surgery for lung cancer.

Methods: A total of 124 patients undergoing surgery for lung cancer were followed for 12 months. Every 2 months, participants reported ADL limitations attributed to PPSP. Cumulative pain impairment scores were calculated from reported limitations in 14 daily activities, and recovery trajectory patterns were analysed.

Results: Daily activities most affected by PPSP were carrying bags, arm elevation, climbing stairs, cleaning floors and coughing, with >50% reporting limitations across all assessment times. Reported pain intensities were generally mild (NRS≤3), but still associated with significant impairment. Some recovery was observed in patients reporting pain at rest, but PPSP was consistently associated with higher cumulative pain impairment scores at all assessments during the 12-month follow-up period.

Conclusions: Findings indicate that persistent postsurgical pain, even of mild intensity, is associated with significant limitations in daily activities up to 12 months post-surgery. Some improvement in pain-related impairment was observed, although limitations remained significantly higher in patients reporting persistent postsurgical pain, as compared to pain-free patients.

Significance: Surgery remains a cornerstone in the treatment of early-stage lung cancer. Despite advances in minimally invasive techniques and rehabilitation, persisting postsurgical pain and pain-related limitations in daily activities may endure. This study investigated specifically the pain-related limitations in activities of daily living and described recovery trajectories during the first 12 postoperative months. Patients with persistent postsurgical pain experienced multiple limitations compared to pain-free patients. Although partial recovery was observed, impairments remained significant for up to 12 months after surgery.

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肺癌手术后与疼痛相关的日常活动障碍:为期一年的前瞻性队列研究。
背景:40%-60%因恶性肿瘤接受肺切除术的患者在胸外科手术后会出现持续性术后疼痛(PPSP)。术后疼痛相关症状很常见,导致日常生活活动(ADL)受限和身体功能退化,严重影响生活质量。由于术后疼痛可能会成为改善术后康复的干预目标,因此与疼痛相关的限制引起了人们的关注。本研究旨在评估肺癌术后头12个月内PPSP与ADL限制之间的关系:共对 124 名接受肺癌手术的患者进行了为期 12 个月的随访。每 2 个月,参与者报告一次因 PPSP 导致的 ADL 受限情况。根据所报告的 14 项日常活动受限情况计算出累积疼痛损伤评分,并对恢复轨迹模式进行分析:结果:受 PPSP 影响最大的日常活动是拎包、抬高手臂、爬楼梯、清洁地板和咳嗽,在所有评估时间内,有超过 50% 的人报告受到限制。所报告的疼痛强度一般较轻(NRS≤3),但仍有明显的功能障碍。在报告休息时疼痛的患者中观察到了一些恢复情况,但在 12 个月的随访期间,在所有评估中,PPSP 始终与较高的累积疼痛损伤评分相关:结论:研究结果表明,手术后持续疼痛,即使是轻度疼痛,也会导致患者在术后 12 个月内的日常活动严重受限。尽管与无痛患者相比,术后持续疼痛患者的活动受限程度仍然明显更高,但与疼痛相关的功能障碍已有所改善:手术仍是治疗早期肺癌的基石。意义:手术仍是治疗早期肺癌的基石,尽管微创技术和康复治疗取得了进步,但术后疼痛和与疼痛相关的日常活动受限仍可能持续存在。本研究特别调查了日常生活中与疼痛相关的限制,并描述了术后前 12 个月的恢复轨迹。与无痛患者相比,术后持续疼痛的患者受到多种限制。虽然观察到了部分恢复,但在术后长达 12 个月的时间里,这些障碍仍然很明显。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
期刊最新文献
Chronic pain among primary fentanyl users: The concept of self-medication. Plasma neurofilament light chain in fibromyalgia: A case control study exploring correlation with clinical and cognitive features. Pain-related impairment in daily activities after lung cancer surgery: A 1-year prospective cohort study. Neural correlates of pain acceptance and the role of the cerebellum: Comment. Prescription time trends in patients with high-impact chronic pain: A National Patient Registry Study.
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