Thoracic Surgery
Conditions
Brief summary
Many patients experience chronic pain after thoracic surgery and this is caused by nerve damage during surgery. Changes in skin sensation (dysaesthesia) is typically associated with chronic nerve pain. We hypothesise that thoracic surgery causes sensory changes. Another hypothesis is that minimally invasive thoracic surgery using video cameras results in less nerve damage and so a smaller area of altered skin sensation, when compared to the traditional method of chest surgery using a large surgical incision. A final hypothesis is that the extent of nerve damage during surgery is associated with the severity of pain early after surgery. This study is designed to compare the total areas of sensory changes after thoracic surgery on the operated side of the chest with that on the non-operated side of the chest. We also aim to identify the type, pattern, location and area of sensory changes associated with thoracic surgery, comparing the operated with the non-operated side of the chest. In addition, we aim to compare the total area of sensory changes between the traditional method of chest surgery and the minimally invasive method of chest surgery. We would also like to determine whether the severity of pain early after surgery is associated with the area of sensory changes.
Interventions
PROCEDUREThoracic Surgery
Patients will either undergo thoracic surgery, specifically thoracotomy (traditional method of chest surgery using a large surgical incision) or video-assisted thoracic surgery (minimally invasive method using video cameras)
Sponsors
NHS Lothian
University of Edinburgh
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients 18 years old or older admitted for elective thoracic surgery
Exclusion criteria
* Emergency thoracic surgery * Thoracic surgery involving sternotomy * Damage to the spinal cord and/ or intercostal nerves prior to surgery * Neurological diseases that may alter the skin sensation to the chest wall such as multiple sclerosis and neuropathies, previous surgery of chest wall, a history of chronic pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Area of dysaesthesia on a patient's chest wall | Days after thoracic surgery (at least 3 hours after chest drain removal) | Areas of dysaesthesia will be detected by applying von frey hair and a sterile, manually blunted 20g hypodermic needle on the patient's chest and back whilst asking the patient to report any sensory changes. The areas of dysaesthesia will be marked on chest using different coloured pens for different types of dysaesthesia. The non-operated side of the chest will act as a control. Tracing paper of known weight per unit area will be cut to the same size and shape as the areas of dysaesthesia. Areas of dysaesthesia will be estimated after placing the tracing paper on a sensitive weight scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acute post-operative pain experienced by the patient | Days after thoracic surgery (at least 3 hours after chest drain removal) | This will be measured using a verbal rating scale: no pain, 0; mild pain, 1; moderate pain, 2; severe pain, 3. |
Other
| Measure | Time frame | Description |
|---|---|---|
| The patient's mood | Days after thoracic surgery (at least 3 hours after chest drain removal) | This will be assessed by asking the patient to complete a hospital anxiety and depression questionnaire. |
Countries
United Kingdom
Outcome results
None listed