Current Thoracic Surgery 2019 , Vol 4 , Issue 1
Is intercostal nerve protection necessary and safe technique for postthoracotomy pain?
Celal Bugra Sezen1,Cemal Aker1,Anil Gokce2,Cem Emrah Kalafat1,Suleyman Anıl Akboga2,Muhammet Sayan2,Ali Celik2,Abdullah Irfan Tastepe2
1Department of Thoracic Surgery,Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
2Department of Thoracic Surgery, Gazi University, School of Medicine, Ankara, Turkey
DOI : 10.26663/cts.2019.0005 Viewed : 3842 - Downloaded : 1361 Background: Our objective in this study was to prospectively evaluate the effects of conventional closure techniques, intracostal suture, and intercostal nerve preservation on postoperative morbidity and longterm pain management.

Materials and Methods: This prospective study was conducted between 2012 and 2015. Three different closure techniques were applied to patients who underwent posterolateral thoracotomy: conventional suture technique, intracostal suture technique, and intracostal suture technique with intercostal nerve preservation. Early postoperative pain level was assessed using a visual analog scale; pain at postoperative six months was assessed with the LANNS pain scale.

Results: Seventy-three male patients (82%) and 16 (18%) female patients were included in the study. Suturing time differed significantly between the groups. At postoperative day 0, 1, and 2, there were significant differences between the groups in pain scores when at rest and while coughing (p < 0.001). Complications occurred in 22 patients (24.7%). There were no significant differences in complications between the groups (p = 0.603). Chronic pain at postoperative six months was more prevalent in group A compared to groups B and C (p < 0.05).

Conclusion: Compared to the conventional technique, the intracostal suture technique with intercostal muscle flap is yields better outcomes in terms of early and chronic postoperative pain. Keywords : pain, chronic pain, thoracotomy, intercostal nerve