Abstract
Background Postoperative pain is commonly evaluated using the numerous rating scale (NRS), visual
analogue scale, or pain scale; however, these assessments are easily affected by various
subjective factors. We measured the degree of postoperative chest pain among different
thoracic surgery approaches using NRS and electrical stimulation measurements.
Methods Seventy patients who underwent lobectomy or segmentectomy were enrolled. Concomitant
with NRS, pain scores were quantitatively measured on postoperative day 2 using an
electrical neurostimulator to compare the degree of pain among three different surgical
approaches: pure video-assisted thoracic surgery (VATS), hybrid VATS, and conventional
thoracotomy. The risk factors associated with postoperative pain were also analyzed.
Results Thirty patients underwent lung resection with pure VATS, while 30 had hybrid VATS,
and 10 had conventional thoracotomy. Among the three surgical approaches, analyzing
the pain score indicated statistically significant differences (pure, 159.50 ± 26.22;
hybrid, 269.36 ± 30.49; thoracotomy, 589.40 ± 141.11; p = 0.003); however, NRS did not obtain a statistically significant difference between
the three approaches (pure, 4.26 ± 0.27; hybrid, 4.96 ± 0.30; thoracotomy, 5.50 ± 0.68;
p = 0.105). A multivariate analysis showed that the surgical approach was an independent
risk factor for postoperative pain as determined by the pain score (pure vs. hybrid,
p = 0.076; pure vs. thoracotomy, p < 0.001).
Conclusion For lung surgery, the differences in surgical approach were an independent risk factor
for postoperative pain. In the early postoperative period, pure VATS was shown to
be the least painful of the three surgical approaches.
Keywords
surgery - complications - video-assisted thoracic surgery - postoperative care
