臺灣博碩士論文加值系統

背景：儘管開胸手術後止痛技術的進步緩解了病患在手術時產生的急性疼痛，有助減少病人住院的時間，但慢性開胸手術術後疼痛（CPTP）仍然困擾著患者。CPTP可能來自肋間神經的受損而導致病患有顯著的神經性症狀，如痛覺過敏和感覺異常。患有異常感覺的患者估計持續數月甚至數年，流行病學上發病率高達40％。 這類疼痛感將影響功能性的活動以及生活品質，雖然已有提出藥物可以減少傷口的疼痛感，但我們想要探討一個非藥物的有效介入，因此本研究將在實驗用大鼠上進行開胸手術，探討是否能藉由跑步機運動改善開胸手術慢性疼痛的症狀。
方法：雄性實驗用大鼠(SD rats)隨機分為5組：開胸手術組(TTR)，開胸手術加上運動組（TRR-E），假手術組(Sham)，假手術加上運動組以及控制組。手術後第10天進行為期6周的跑步機訓練，研究者會藉由Von-Frey以及丙酮測試量化疼痛相關的行為並做紀錄。
結果：開胸手術後第10天，大鼠表現出明顯對輕觸覺刺激及冷刺激的過度敏感。TRR組和TRR-E組的閾值相對於控制組有明顯的減少。在跑步機介入後第28天TRR-E組的機械性退縮閾值相較於TRR組有明顯的上升，但仍然低於控制組的; 對於冷的感覺異常在第28天後也有逆轉的現象，而另外三組的閾值在實驗中是相似的，沒有達到顯著差異。 在介白素-1beta (IL-1β)與腫瘤壞死因子-α(TNF-α)的表現上，開胸手術過後的老鼠相較於控制組老鼠有顯著的增加，跑步機介入後，雖然與手術組沒有達顯著差異，但表現水平有減少的趨勢。
結論: 我們結論出跑步機的介入減緩了慢性胸廓切開術後的疼痛。 這似乎為臨床患者提供了有效的方法，有助於他們疼痛管理以及生活質量的提升。

Background: Although advances in analgesia techniques have alleviated the acute pain that occurs after thoracotomy, which reduces the length of hospital stay, but chronic pain after thoracotomy (CPTP) still bother patients. CPTP may be caused by damage to the intercostal nerves result in significant neurological symptoms such as hyperalgesia and allodynia. Patients with abnormal sensations are estimated to last for months or even years, with an epidemiological incidence of up to 40%. This pain will affects functional activity and quality of life. Despite drug can partially suppress pain around surgical wound, but we want to explore a non-pharmaceutical intervention. In this study, we will evaluate whether treadmill exercise training reduces chronic post-thoracotomy pain in a rat model after thoracotomy.
Methods: Male SD rats were distributed randomly into 5 groups: thoracotomy with rib retraction group (TRR) and TRR with treadmill exercise group (TRR-E), thoracotomy without rib retraction group (Sham), thoracotomy without rib retraction with exercise group (Sham-E), and control group. After thoracotomy procedure, the rats were trained to run for 6 weeks. Pain-related behavioural test was measured and the threshold was being record by Von-Frey filaments or acetone.
Result: On day 10 after thoracotomy, rats exhibited a marked and continued hypersensitivity to von Frey tactile and cold stimuli. The threshold of TRR and TRR-E group were significant decrease compared with control group (P < 0.05), but there are similar within Sham and sham-E group. Mechanical withdrawal thresholds were increased compared with TRR (P < 0.05) following 35 days of treadmill intervention, but thresholds remained lower than control rats; moreover, cold allodynia was also reversed on 35 days in TRR-E group (P < 0.05). The threshold was not obvious different within other 3 groups in the experiment. After thoracotomy, rats demonstrated higher IL-1βand TNF-αexpression than control group, and showed decrease trend after 6 weeks treadmill intervention.
Conclusion: We concluded that forced treadmill running alleviated chronic post-thoracotomy pain. This appear provide an effective way for patients in clinical, it''s helpful about their pain management and life quality.

目錄
1.Introduction 1
1.1Review of literature 2
1.1.1 Thoracotomy pain 3
1.1.2 Treatment strategies for post-thoracotomy pain 9
1.2 The aim of present study 15
2.Experimental Material and Method 17
2.1 Animals 17
2.2 Experiment Design and Groups 17
2.3 Experiment Procedure and Thoracotomy 17
2.4 Treadmill Training Protocol 19
2.5 Tactile and Cold Responsiveness 19
2.6 Cytokines Evaluation 20
2.7 Statistical Analysis 20
3.Results 22
4.Discussion 24
5.Conclusions 29
References 30

References
Bayman, E. O., Parekh, K. R., Keech, J., Selte, A., & Brennan, T. J. (2017). A Prospective Study of Chronic Pain after Thoracic Surgery. Anesthesiology, 126(5), 938-951. doi: 10.1097/ALN.0000000000001576
Belmonte, C., Brock, J. A., & Viana, F. (2009). Converting cold into pain. Exp Brain Res, 196(1), 13-30. doi: 10.1007/s00221-009-1797-2
Bement, M. K., & Sluka, K. A. (2005). Low-intensity exercise reverses chronic muscle pain in the rat in a naloxone-dependent manner. Arch Phys Med Rehabil, 86(9), 1736-1740. doi: 10.1016/j.apmr.2005.03.029
Boadas-Vaello, P., Castany, S., Homs, J., Alvarez-Perez, B., Deulofeu, M., & Verdu, E. (2016). Neuroplasticity of ascending and descending pathways after somatosensory system injury: reviewing knowledge to identify neuropathic pain therapeutic targets. Spinal Cord, 54(5), 330-340. doi: 10.1038/sc.2015.225
Buvanendran, A., Kroin, J. S., Kerns, J. M., Nagalla, S. N., & Tuman, K. J. (2004). Characterization of a new animal model for evaluation of persistent postthoracotomy pain. Anesth Analg, 99(5), 1453-1460; table of contents. doi: 10.1213/01.ANE.0000134806.61887.0D
Carballo-Villalobos, A. I., Gonzalez-Trujano, M. E., Alvarado-Vazquez, N., & Lopez-Munoz, F. J. (2017). Pro-inflammatory cytokines involvement in the hesperidin antihyperalgesic effects at peripheral and central levels in a neuropathic pain model. Inflammopharmacology, 25(2), 265-269. doi: 10.1007/s10787-017-0326-3
Caspersen CJ, Powell KE, Christenson GM. (1985). Physical Activity, Exercise, and Physical Fitness: Definitions and Distinctions for Health-Related Research.
Chaplan, S. R., Bach, F. W., Pogrel, J. W., Chung, J. M., & Yaksh, T. L. (1994). Quantitative assessment of tactile allodynia in the rat paw. J Neurosci Methods, 53(1), 55-63.
Chen, Y. W., Chen, S. H., Chou, W., Lo, Y. M., Hung, C. H., & Lin, M. T. (2007). Exercise pretraining protects against cerebral ischaemia induced by heat stroke in rats. Br J Sports Med, 41(9), 597-602. doi: 10.1136/bjsm.2006.033829
Chen, Y. W., Hsieh, P. L., Chen, Y. C., Hung, C. H., & Cheng, J. T. (2013). Physical exercise induces excess hsp72 expression and delays the development of hyperalgesia and allodynia in painful diabetic neuropathy rats. Anesth Analg, 116(2), 482-490. doi: 10.1213/ANE.0b013e318274e4a0
Chen, Y. W., Li, Y. T., Chen, Y. C., Li, Z. Y., & Hung, C. H. (2012). Exercise training attenuates neuropathic pain and cytokine expression after chronic constriction injury of rat sciatic nerve. Anesth Analg, 114(6), 1330-1337. doi: 10.1213/ANE.0b013e31824c4ed4
Chen, Y. W., Tzeng, J. I., Lin, M. F., Hung, C. H., & Wang, J. J. (2014). Forced treadmill running suppresses postincisional pain and inhibits upregulation of substance P and cytokines in rat dorsal root ganglion. J Pain, 15(8), 827-834. doi: 10.1016/j.jpain.2014.04.010
Choi, Y., Yoon, Y. W., Na, H. S., Kim, S. H., & Chung, J. M. (1994). Behavioral signs of ongoing pain and cold allodynia in a rat model of neuropathic pain. Pain, 59(3), 369-376.
Ciaramitaro, P., Mondelli M, Logullo F., Grimaldi S., Battiston B., Sard A., Scarinzi C., Migliaretti G., Faccani G., Cocito D; Italian Network for Traumatic Neuropathies. (2010). Traumatic peripheral nerve injuries: epidemiological findings, neuropathic pain and quality of life in 158 patients. J Peripher Nerv Syst, 15(2), 120-127. doi: 10.1111/j.1529-8027.2010.00260.x
Cobianchi, S., Marinelli, S., Florenzano, F., Pavone, F., & Luvisetto, S. (2010). Short- but not long-lasting treadmill running reduces allodynia and improves functional recovery after peripheral nerve injury. Neuroscience, 168(1), 273-287. doi: 10.1016/j.neuroscience.2010.03.035
Dajczman, Esther, Gordon, Ann, Kreisman, Harvey, & Wolkove, Norman. (1991). Long-Term Postthoracotomy Pain. Chest, 99(2), 270-274. doi: 10.1378/chest.99.2.270
Daniel W. Moyse, MD, Alan D. Kaye, MD, PhD, James H. Diaz, MD,, & Muhammad Y. Qadri, MD, PhD, David Lindsay, MD, and Srinivas Pyati, MD. (2017). Perioperative Ketamine Administration for
Thoracotomy Pain.
de Azambuja, G., Hortscht, U., Hoheisel, U., Oliveira Fusaro, M. C., Mense, S., & Treede, R. D. (2018). Short-term swimming exercise attenuates the sensitization of dorsal horn neurons in rats with NGF-induced low back pain. Eur J Pain. doi: 10.1002/ejp.1230
Detterbeck, F. C. (2005). Efficacy of methods of intercostal nerve blockade for pain relief after thoracotomy. Ann Thorac Surg, 80(4), 1550-1559. doi: 10.1016/j.athoracsur.2004.11.051
Devor, M. (2009). Ectopic discharge in Abeta afferents as a source of neuropathic pain. Exp Brain Res, 196(1), 115-128. doi: 10.1007/s00221-009-1724-6
Dib-Hajj, S. D., Cummins, T. R., Black, J. A., & Waxman, S. G. (2010). Sodium channels in normal and pathological pain. Annu Rev Neurosci, 33, 325-347. doi: 10.1146/annurev-neuro-060909-153234
Doan, L. V., Augustus, J., Androphy, R., Schechter, D., & Gharibo, C. (2014). Mitigating the impact of acute and chronic post-thoracotomy pain. J Cardiothorac Vasc Anesth, 28(4), 1048-1056. doi: 10.1053/j.jvca.2014.02.021
Dobson, J. L., McMillan, J., & Li, L. (2014). Benefits of exercise intervention in reducing neuropathic pain. Front Cell Neurosci, 8, 102. doi: 10.3389/fncel.2014.00102
Dravid, R. M., & Paul, R. E. (2007). Interpleural block - part 1. Anaesthesia, 62(10), 1039-1049. doi: 10.1111/j.1365-2044.2007.05183.x
Dworkin, R. H., Backonja, M., Rowbotham, M. C., Allen, R. R., Argoff, C. R., Bennett, G. J., . . . Weinstein, S. M. (2003). Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol, 60(11), 1524-1534. doi: 10.1001/archneur.60.11.1524
Erden, Sevilay, & Senol Celik, Sevilay. (2015). The effect of transcutaneous electrical nerve stimulation on post-thoracotomy pain. Contemporary Nurse, 51(2-3), 163-170. doi: 10.1080/10376178.2016.1166971
Fabiana Cristina Ferreira , Adriana Machado Issy , Rioko Kimiko Sakata. (2011). Assessing the Effects of Transcutaneous Electrical Nerve.
Ferreira, F. C., Issy, A. M., & Sakata, R. K. (2011). Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia. Rev Bras Anestesiol, 61(5), 561-567, 308-510. doi: 10.1016/s0034-7094(11)70067-8
Fiorelli, A., Izzo AC., Frongillo EM., Del Prete A., Liguori G., Di Costanzo E., Vicidomini G., Santini M. (2016). Efficacy of wound analgesia for controlling post-thoracotomy pain: a randomized double-blind studydagger. Eur J Cardiothorac Surg, 49(1), 339-347. doi: 10.1093/ejcts/ezv097
Fiorelli, A., Morgillo F., Milione R., Pace MC., Passavanti MB., Laperuta P., Aurilio C., Santini M. (2012). Control of post-thoracotomy pain by transcutaneous electrical nerve stimulation: effect on serum cytokine levels, visual analogue scale, pulmonary function and medication. Eur J Cardiothorac Surg, 41(4), 861-868; discussion 868. doi: 10.1093/ejcts/ezr108
Gerner, P. (2008). Postthoracotomy pain management problems. Anesthesiol Clin, 26(2), 355-367, vii. doi: 10.1016/j.anclin.2008.01.007
Ghelardini, C., Desaphy JF., Muraglia M., Corbo F., Matucci R., Dipalma A., Bertucci C., Pistolozzi M., Nesi M., Norcini M., Franchini C., Camerino DC. (2010). Effects of a new potent analog of tocainide on hNav1.7 sodium channels and in vivo neuropathic pain models. Neuroscience, 169(2), 863-873. doi: 10.1016/j.neuroscience.2010.05.019
Gottschalk, A., Cohen, S. P., Yang, S., & Ochroch, E. A. (2006). Preventing and treating pain after thoracic surgery. Anesthesiology, 104(3), 594-600.
Hoffman, A. J., & Brintnall, R. A. (2017). A Home-based Exercise Intervention for Non-Small Cell Lung Cancer Patients Post-Thoracotomy. Semin Oncol Nurs, 33(1), 106-117. doi: 10.1016/j.soncn.2016.11.011
Hung, C. H., Chen, Y. W., Shao, D. Z., Chang, C. N., Tsai, Y. Y., & Cheng, J. T. (2008). Exercise pretraining attenuates endotoxin-induced hemodynamic alteration in type I diabetic rats. Appl Physiol Nutr Metab, 33(5), 976-983. doi: 10.1139/h08-081
Hutchinson, K. J., Gomez-Pinilla, F., Crowe, M. J., Ying, Z., & Basso, D. M. (2004). Three exercise paradigms differentially improve sensory recovery after spinal cord contusion in rats. Brain, 127(Pt 6), 1403-1414. doi: 10.1093/brain/awh160
Jensen, T. S., Baron, R., Haanpaa, M., Kalso, E., Loeser, J. D., Rice, A. S., & Treede, R. D. (2011). A new definition of neuropathic pain. Pain, 152(10), 2204-2205. doi: 10.1016/j.pain.2011.06.017
Jensen, Troels S., & Finnerup, Nanna B. (2014). Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms. The Lancet Neurology, 13(9), 924-935. doi: 10.1016/s1474-4422(14)70102-4
Joshi GP, Bonnet F, Shah R,et al. (2008). A Systematic Review of Randomized Trials Evaluating Regional Techniques for Postthoracotomy Analgesia. 107(3), 1040. doi: 10.1213/ane.0b013e31817e7b40
Ju, H., Feng, Y., Yang, B. X., & Wang, J. (2008). Comparison of epidural analgesia and intercostal nerve cryoanalgesia for post-thoracotomy pain control. Eur J Pain, 12(3), 378-384. doi: 10.1016/j.ejpain.2007.07.011
Jun Shen, MD, Lyle E. Fox, PhD, & Jianguo Cheng, MD, PhD. (2013). Swim Therapy Reduces Mechanical Allodynia and Thermal Hyperalgesia Induced by Chronic Constriction Nerve Injury in Rats.
Kami, K., Tajima, F., & Senba, E. (2017). Exercise-induced hypoalgesia: potential mechanisms in animal models of neuropathic pain. Anat Sci Int, 92(1), 79-90. doi: 10.1007/s12565-016-0360-z
Katz, J., & Seltzer, Z. (2009). Transition from acute to chronic postsurgical pain: risk factors and protective factors. Expert Rev Neurother, 9(5), 723-744. doi: 10.1586/ern.09.20
Kehlet, Henrik, Jensen, Troels S., & Woolf, Clifford J. (2006). Persistent postsurgical pain: risk factors and prevention. The Lancet, 367(9522), 1618-1625. doi: 10.1016/s0140-6736(06)68700-x
Khalil, K. G., Boutrous, M. L., Irani, A. D., Miller, C. C., 3rd, Pawelek, T. R., Estrera, A. L., & Safi, H. J. (2015). Operative Intercostal Nerve Blocks With Long-Acting Bupivacaine Liposome for Pain Control After Thoracotomy. Ann Thorac Surg, 100(6), 2013-2018. doi: 10.1016/j.athoracsur.2015.08.017
Khanbhai, M., Yap, K. H., Mohamed, S., & Dunning, J. (2014). Is cryoanalgesia effective for post-thoracotomy pain? Interact Cardiovasc Thorac Surg, 18(2), 202-209. doi: 10.1093/icvts/ivt468
Kluding, P. M., Pasnoor, M., Singh R., Jernigan S., Farmer K., Rucker J., Sharma NK., Wright DE. (2012). The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications, 26(5), 424-429. doi: 10.1016/j.jdiacomp.2012.05.007
Koehler, R. P., & Keenan, R. J. (2006). Management of postthoracotomy pain: acute and chronic. Thorac Surg Clin, 16(3), 287-297. doi: 10.1016/j.thorsurg.2006.05.006
Korb, A., Bonetti, L. V., da Silva SA., Marcuzzo S., Ilha J., Bertagnolli M., Partata WA., Faccioni-Heuser MC. (2010). Effect of treadmill exercise on serotonin immunoreactivity in medullary raphe nuclei and spinal cord following sciatic nerve transection in rats. Neurochem Res, 35(3), 380-389. doi: 10.1007/s11064-009-0066-x
Kruger, Marelise, & McRae, Karen. (1999). PAIN MANAGEMENT IN CARDIOTHORACIC PRACTICE. Surgical Clinics of North America, 79(2), 387-400. doi: 10.1016/S0039-6109(05)70388-1
Kuphal, K. E., Fibuch, E. E., & Taylor, B. K. (2007). Extended swimming exercise reduces inflammatory and peripheral neuropathic pain in rodents. J Pain, 8(12), 989-997. doi: 10.1016/j.jpain.2007.08.001
Kutlu CA , Akin H , Olcmen A , Biliciler U , Kayserilioglu A , & M, Olcmen. (2001). Shoulder-girdle strength after standard and lateral muscle-sparing thoracotomy.
Larry F. Chu, MD, MS , , Martin S. Angst, MD, & David Clark, MD, PhD. (2008). Opioid-induced Hyperalgesia in Humans Molecular Mechanisms and Clinical Considerations.
Li, W. (2003). The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy. European Journal of Cardio-Thoracic Surgery, 23(3), 390-396. doi: 10.1016/s1010-7940(02)00795-9
Lisa V. Doan, MD, Jermaine Augustus, MD, Rachel Androphy, MD, Douglas Schechter, MD, & Christopher Gharibo, MD. (2014). Mitigating the Impact of Acute and Chronic Post-thoracotomy Pain.
Lopez-Alvarez, V. M., Puigdomenech, M., Navarro, X., & Cobianchi, S. (2018). Monoaminergic descending pathways contribute to modulation of neuropathic pain by increasing-intensity treadmill exercise after peripheral nerve injury. Exp Neurol, 299(Pt A), 42-55. doi: 10.1016/j.expneurol.2017.10.007
Macrae, W. A. (2008). Chronic post-surgical pain: 10 years on. Br J Anaesth, 101(1), 77-86. doi: 10.1093/bja/aen099
Mezzani, A., Grassi B., Jones AM., Giordano A., Corrà U., Porcelli S., Della Bella S., Taddeo A., Giannuzzi P. (2013). Speeding of pulmonary VO2 on-kinetics by light-to-moderate-intensity aerobic exercise training in chronic heart failure: clinical and pathophysiological correlates. Int J Cardiol, 167(5), 2189-2195. doi: 10.1016/j.ijcard.2012.05.124
Mishra, A., Nar, A. S., Bawa, A., Kaur, G., Bawa, S., & Mishra, S. (2013). Pregabalin in Chronic Post-thoracotomy Pain. J Clin Diagn Res, 7(8), 1659-1661. doi: 10.7860/JCDR/2013/5707.3239
Miyazaki, T., Sakai T., Tsuchiya T., Yamasaki N., Tagawa T., Mine M., Shibata Y., Nagayasu T. (2011). Assessment and follow-up of intercostal nerve damage after video-assisted thoracic surgery. Eur J Cardiothorac Surg, 39(6), 1033-1039. doi: 10.1016/j.ejcts.2010.10.015
Moyse, D. W., Kaye, A. D., Diaz, J. H., Qadri, M. Y., Lindsay, D., & Pyati, S. (2017). Perioperative Ketamine Administration for Thoracotomy Pain. Pain Physician, 20(3), 173-184.
Mustola, S. T., Lempinen, J., Saimanen, E., & Vilkko, P. (2011). Efficacy of thoracic epidural analgesia with or without intercostal nerve cryoanalgesia for postthoracotomy pain. Ann Thorac Surg, 91(3), 869-873. doi: 10.1016/j.athoracsur.2010.11.014
Nara, T., Saito, S., Obata, H., & Goto, F. (2001). A rat model of postthoracotomy pain: behavioural and spinal cord NK-1 receptor assessment. Can J Anaesth, 48(7), 665-676. doi: 10.1007/bf03016201
Nau, C. (2010). [Pathophysiology of chronic postoperative pain]. Anasthesiol Intensivmed Notfallmed Schmerzther, 45(7-8), 480-486; quiz 487. doi: 10.1055/s-0030-1262477
Ng, A., & Swanevelder, J. (2007). Pain relief after thoracotomy: is epidural analgesia the optimal technique? Br J Anaesth, 98(2), 159-162. doi: 10.1093/bja/ael360
Norrbrink, C., Lofgren, M., Hunter, J. P., & Ellis, J. (2012). Patients'' perspectives on pain. Top Spinal Cord Inj Rehabil, 18(1), 50-56. doi: 10.1310/sci1801-50
Ochroch, E. A., & Gottschalk, A. (2005). Impact of acute pain and its management for thoracic surgical patients. Thorac Surg Clin, 15(1), 105-121. doi: 10.1016/j.thorsurg.2004.08.004
Pain, International Association for the Study of. (1986). International Association for the Study of Pain, Subcommittee of Taxonomy. Classification of chronic pain. Pain 1986: suppl. 3: S138–S139.
Pasquale Sansone, Maria Caterina Pace, Maria Beatrice Passavanti, Vincenzo Pota, Umberto Colella, & Aurilio, Caterina. (2015). Epidemiology and incidence of acute and chronic Post-Surgical pain.
Perttunen, K. (1999). Chronic pain after thoracic surgery: a follow-up study.
Rahman, W., & Dickenson, A. H. (2011). Recent Developments in Neuropathic Pain Mechanisms: Implications for Treatment. Rev Pain, 5(2), 21-25. doi: 10.1177/204946371100500204
Reeve, Julie, Stiller, Kathy, Nicol, Kristine, McPherson, Kathryn M., Birch, Paul, Gordon, Ian R., & Denehy, Linda. (2010). A postoperative shoulder exercise program improves function and decreases pain following open thoracotomy: a randomised trial. Journal of Physiotherapy, 56(4), 245-252. doi: 10.1016/s1836-9553(10)70007-2
Reiestad, Finn, & Str??mskag, Kjell Erik. (1986). Interpleural Catheter in the Management of Postoperative Pain A Preliminary Report. Regional Anesthesia and Pain Medicine, 11(2), 89-91.
Ren, K., & Dubner, R. (2010). Interactions between the immune and nervous systems in pain. Nat Med, 16(11), 1267-1276. doi: 10.1038/nm.2234
Rodriguez-Aldrete, D., Candiotti, K. A., Janakiraman, R., & Rodriguez-Blanco, Y. F. (2016). Trends and New Evidence in the Management of Acute and Chronic Post-Thoracotomy Pain-An Overview of the Literature from 2005 to 2015. J Cardiothorac Vasc Anesth, 30(3), 762-772. doi: 10.1053/j.jvca.2015.07.029
Saby, A., Swaminathan, K., Pangarkar, S., & Tribuzio, B. (2016). Alleviating Thoracotomy Pain With Intercostal Liposomal Bupivacaine: A Case Report. PM R, 8(11), 1119-1122. doi: 10.1016/j.pmrj.2016.06.003
Safakhah, H. A., Moradi Kor, N., Bazargani, A., Bandegi, A. R., Gholami Pourbadie, H., Khoshkholgh-Sima, B., & Ghanbari, A. (2017). Forced exercise attenuates neuropathic pain in chronic constriction injury of male rat: an investigation of oxidative stress and inflammation. J Pain Res, 10, 1457-1466. doi: 10.2147/JPR.S135081
Sansone P, Passavanti MB., Fiorelli A., Aurilio C., Colella U., De Nardis L., Donatiello V., Pota V., Pace MC. (2017). Efficacy of the topical 5% lidocaine medicated plaster in the treatment of chronic post-thoracotomy neuropathic pain.
Schmidt-Lucke, C., Rössig L., Fichtlscherer S., Vasa M., Britten M., Kämper U., Dimmeler S., Zeiher AM. (2005). Reduced number of circulating endothelial progenitor cells predicts future cardiovascular events: proof of concept for the clinical importance of endogenous vascular repair. Circulation, 111(22), 2981-2987. doi: 10.1161/CIRCULATIONAHA.104.504340
Schmitz, K. H., Courneya KS., Matthews C., Demark-Wahnefried W., Galvão DA., Pinto BM., Irwin ML., Wolin KY., Segal RJ., Lucia A., Schneider CM., von Gruenigen VE., Schwartz AL; American College of Sports Medicine. (2010). American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc, 42(7), 1409-1426. doi: 10.1249/MSS.0b013e3181e0c112
Scholz, J., & Woolf, C. J. (2007). The neuropathic pain triad: neurons, immune cells and glia. Nat Neurosci, 10(11), 1361-1368. doi: 10.1038/nn1992
Schulte, T., Schniewind, B., Dohrmann, P., Kuchler, T., & Kurdow, R. (2009). The extent of lung parenchyma resection significantly impacts long-term quality of life in patients with non-small cell lung cancer. Chest, 135(2), 322-329. doi: 10.1378/chest.08-1114
Senard, M., Deflandre EP., Ledoux D., Roediger L., Hubert BM., Radermecker M., Libbrecht D., Joris JL. (2010). Effect of celecoxib combined with thoracic epidural analgesia on pain after thoracotomy. Br J Anaesth, 105(2), 196-200. doi: 10.1093/bja/aeq129
Sengupta, S. (2015). Post-operative pulmonary complications after thoracotomy. Indian J Anaesth, 59(9), 618-626. doi: 10.4103/0019-5049.165852
Sinaei, M., & Kargarfard, M. (2015). The evaluation of BMI and serum beta-endorphin levels: the study of acute exercise intervention. J Sports Med Phys Fitness, 55(5), 488-494.
Singh, J. A., & Lewallen, D. (2009). Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty. Clin Rheumatol, 28(12), 1419-1430. doi: 10.1007/s10067-009-1267-z
Stagg, Ph D. Nicola J., Mata, B. S. Heriberto P., Ibrahim, Ph D. M. D. Mohab M., Henriksen, Ph D. Erik J., Porreca, Ph D. Frank, Vanderah, Ph D. Todd W., & Philip Malan, Ph D. M. D. T. (2011). Regular Exercise Reverses Sensory Hypersensitivity in a Rat Neuropathic Pain ModelRole of Endogenous Opioids. Anesthesiology, 114(4), 940-948. doi: 10.1097/ALN.0b013e318210f880
Tung, K. W., Behera, D., & Biswal, S. (2015). Neuropathic pain mechanisms and imaging. Semin Musculoskelet Radiol, 19(2), 103-111. doi: 10.1055/s-0035-1547371
WE, Hurford, RP, Dutton, PH, Alfille, D, Clement, & RS, Wilson. (1993). Comparison of thoracic and lumbar epidural infusions of bupivacaine and fentanyl for post-thoracotomy analgesia.
Whitehead, K. J., Smith, C. G., Delaney, S. A., Curnow, S. J., Salmon, M., Hughes, J. P., & Chessell, I. P. (2010). Dynamic regulation of spinal pro-inflammatory cytokine release in the rat in vivo following peripheral nerve injury. Brain Behav Immun, 24(4), 569-576. doi: 10.1016/j.bbi.2009.12.007
Wildgaard, K., Ringsted, T. K., Hansen, H. J., Petersen, R. H., & Kehlet, H. (2016). Persistent postsurgical pain after video-assisted thoracic surgery--an observational study. Acta Anaesthesiol Scand, 60(5), 650-658. doi: 10.1111/aas.12681
Wolf, Marina E, & Khansa, Mohamad R. (1991). Repeated administration of MK-801 produces sensitization to its own locomotor stimulant effects but blocks sensitization to amphetamine. Brain research, 562(1), 164-168.
Wu, Christopher L., & Raja, Srinivasa N. (2011). Treatment of acute postoperative pain. The Lancet, 377(9784), 2215-2225. doi: 10.1016/s0140-6736(11)60245-6
Wulff, H., Castle, N. A., & Pardo, L. A. (2009). Voltage-gated potassium channels as therapeutic targets. Nat Rev Drug Discov, 8(12), 982-1001. doi: 10.1038/nrd2983
Yim AP, Wan S, Lee TW, & AA., Arifi. (2000). VATS Lobectomy Reduces Cytokine Responses Compared With Conventional Surgery.
Yoo, D. Y., Chae J., Jung HY., Yim HS., Kim JW., Nam SM., Kim DW., Choi JH., Seong JK., Yoon YS., Hwang IK. (2015). Treadmill exercise is associated with reduction of reactive microgliosis and pro-inflammatory cytokine levels in the hippocampus of type 2 diabetic rats. Neurol Res, 37(8), 732-738. doi: 10.1179/1743132815Y.0000000015
Zhuo, M., Wu, G., & Wu, L. J. (2011). Neuronal and microglial mechanisms of neuropathic pain. Mol Brain, 4, 31. doi: 10.1186/1756-6606-4-31