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Background: Pre-clinical research has shown [beta]2-adrenoceptors to be essential for the antiallodynic action of antidepressant drugs in murine models of neuropathic pain and that sustained treatment with [beta]2-agonists has an antiallodynic action. Here, we clinically investigated whether chronic [beta]2-agonist treatments may influence the incidence of post-thoracotomy chronic pain, defined as pain that recurs or persists along a thoracotomy scar more than 2 months after surgery, either neuropathic or non-neuropathic.

Methods: We conducted an epidemiological study on patients operated by thoracotomy. Demographic data, medical history and treatments concomitant to the surgery were recorded at a follow-up visit. Information on perioperative treatments was collected from the anaesthesia records and confirmed by the patients. In patients with pain at the surgery level, post-thoracotomy chronic pain was assessed by clinical examination and numeric scale. Physical examination and DN4 questionnaire were used to discriminate neuropathic and non-neuropathic chronic pain at scar level.

Results: One hundred and eighty-nine patients were included. Eighty-one patients reported persisting thoracic pain, with neuropathic characteristics in 58 of them (30% of the 189 patients). The most common chronic drugs during the perioperative period were inhaled [beta]2-agonists (28.6%). The chronic use of [beta]2-agonists was an independent predictor of thoracic neuropathic pain (but not of non-neuropathic pain) and was associated with a five-fold decrease in the relative incidence of neuropathic pain [OR = 0.19 (0.06-0.45)].

Conclusions: These data suggest a possible influence of chronic [beta]2-agonist treatments on neuropathic pain secondary to thoracotomy. This apparent preventive effect of [beta]2-agonist treatments should warrant controlled clinical trials.

(C) 2015 John Wiley & Sons, Ltd