Prediction of Chronic Pain by the Pain Monitor

Prediction of the Occurrence of Chronic Pain After Thoracotomy by Measuring Preoperative Skin Conductance (Pain Monitor Device)

The skin conductance algesimeter (Pain Monitor™, Med-Storm Innovation AS, NO-0264 Oslo, Norway)) reflects the sympathetic nervous system by the measurement of the skin conductance of the palm of the hand. SCA detects nociceptive pain fast and continuously, specific to the individual, with higher sensitivity and specificity than other available objective methods.

The skin conductance response to a calibrated noxious stimulus varies among patients. It defines two types of people depending on its magnitude.

The investigators assume that the importance of skin conductance response to a noxious stimulus predicts the occurrence of chronic pain in patients operated by thoracotomy.

Inclusion Criteria:

• adult patients of both sexes
• planned pulmonary resection for cancer performed by a posterolateral thoracotomy
• thoracic epidural analgesia

Exclusion Criteria:

• pregnancy,
• morbid obesity,
• insulin-dependent diabetes with dysautonomia,
• inability to proceed with anesthesia using the BIS signal,
• known allergy to remifentanil, propofol, atracurium or to levobupivacaine,
• contra-indication to nefopam
• contra-indication to ketoprofen