Postthoracotomy syndrome and postherpetic neuralgia

Postthoractomy syndrome (PTS) is a multifactorial disease process which has never been adequately described. This, in turn, has led to a discrepancy in the literature concerning the signs and symptoms which constitute PTS and what are the most efficacious treatment modalities that should be used. The most important fact before instituting therapy for PTS, is that recurrent disease must be ruled out. Once this is done, a stepped-treatment regimen can be instituted. Postherpetic neuralgia (PHN) is a disease state which afflicts 10% to 15% of patients who become infected with herpes zoster. At this time, there appears to be no definitive treatment regimen for PHN. However, there are various treatment modalities which can significantly decrease the pain associated with the disease. There seem to be many promising agents undergoing scientific trials, so that a definitive treatment for PHN may soon be available.