Less invasive thoracotomies may reduce early postoperative pain. The aims of this study were to identify pain trajectories from postoperative day 0 to 5 after posterolateral and axillary thoracotomies and identify potential factors related to the worst" trajectory. Patients undergoing a posterolateral (92 patients) or axillary (89 patients) thoracotomy between July 2014 and November 2015 were analyzed in this prospective monocentric cohort study. The best-fitting model resulted in four pain trajectory groups: trajectory 1, the “worst”, with 29.8% of the patients with permanent significant pain; trajectory 2 with patients with low pain (32.6%), trajectory 3 with patients with a steep decrease in pain (22.7%), trajectory 4 with patients with a steep increase (14.9%). According to a multinomial logistic model multivariable analysis, some predictive factors allow differentiation between trajectory groups 1 and 2. Risk factors for permanent pain are the existence of preoperative pain (OR =6.94, CI 95% [1.54-31.27]) and scar length (OR=1.20 [1.05-1.38])). In contrast, ASA class III is a protective factor to be in group 1 (OR=0.02 [0.001-0.52]). In conclusion, early postoperative pain can be characterized by four trajectories and preoperative pain is the major factor for the worst trajectory of early postoperative pain.

eCRF