Incident physician-diagnosed chronic postsurgical pain higher in women than in men after open thoracotomy: Study

Post-operative pain is commonly experienced across various surgeries, with open thoracotomy procedures being particularly associated with chronic postsurgical pain (CPSP). Despite this, the impact of CPSP specifically on women following open thoracotomy remains inadequately studied. Recent observational cohort study examined the incidence of chronic postsurgical pain (CPSP) in women after open thoracotomy, as well as compared relevant patient and procedural variables between women and men. The study was conducted in ten university-affiliated hospitals and included 96 women and 137 men as subjects. The key findings are: 1. The incidence of CPSP was significantly higher in women (53.1%) compared to men (38.0%) after open thoracotomy (p=0.023). 2. At baseline, women had significantly worse scores on psychological measures, including perception of mental state (p=0.01), depression (p=0.006), and catastrophizing (p<0.001). Women also reported more preoperative pain in the operative area (p=0.011) and other areas (p=0.030) compared to men. 3. There were no differences between women and men in pain intensity, interference caused by pain, or quality of life measures at 4 months post-surgery in those diagnosed with CPSP. However, the interaction between sex and scores on the mental component of the SF-12 quality of life measure was significant (p=0.027), with women showing an increase of 3 points and men showing a decrease of 2 points. 4. The only independent predictors of CPSP identified were normal body mass index (OR 2.25) and presence of preoperative pain in other areas (OR 3.22).

Conclusion

In conclusion, this study demonstrates a significantly higher incidence of physician-diagnosed CPSP in women compared to men after open thoracotomy. The findings highlight the importance of incorporating sex and gender considerations in future research on chronic pain in surgical settings.

Key Points

1. The incidence of chronic postsurgical pain (CPSP) was significantly higher in women (53.1%) compared to men (38.0%) after open thoracotomy.

2. At baseline, women had significantly worse scores on psychological measures, including perception of mental state, depression, and catastrophizing. Women also reported more preoperative pain in the operative area and other areas compared to men.

3. There were no differences between women and men in pain intensity, interference caused by pain, or quality of life measures at 4 months post-surgery in those diagnosed with CPSP. However, the interaction between sex and scores on the mental component of the SF-12 quality of life measure was significant, with women showing an increase of 3 points and men showing a decrease of 2 points.

4. The only independent predictors of CPSP identified were normal body mass index (OR 2.25) and presence of preoperative pain in other areas (OR 3.22).

5. The study demonstrates a significantly higher incidence of physician-diagnosed CPSP in women compared to men after open thoracotomy.

6. The findings highlight the importance of incorporating sex and gender considerations in future research on chronic pain in surgical settings.

Reference –

Gisela Roca et al. (2024). Sex Differences In Chronic Postsurgical Pain After Open Thoracotomy.. *Journal Of Cardiothoracic And Vascular Anesthesia*. https://doi.org/10.1053/j.jvca.2024.08.039