[Pathophysiology and epidemiology of pain in thoracic surgery].

Acute and chronic pain are significant problems after thoracic surgery with a multifactorial pathogenesis. On the one hand iatrogenic procedures as surgical access and complexity of treatment procedures, and on the other hand constitutional factors as psychosocial comorbidities affect individual pain threshold and the development of a Postthoracic Pain Syndrome (PTPS). Special phenomena associated with thoracic surgery like ipsitateral shoulder pain and neuropathic pain are discussed. The characterization of pathophysiological pathways wants to point out treatment options. In conclusion there is a need for well organized, multimodal pain therapy concepts to minimize the risk of perioperative and chronic pain.