Background Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0 h, 3 h, 6 h, 12 h, 24 h, 48 h, and 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results Among the 307 patients considered in this study, the incidence of CPBS was 28% [95% CI 23.1–33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95% CI], 2.99 [1.13–7.87], p = 0.03), preoperative use of pain medications (OR [95% CI], 2.04 [1.20–3.46], p = 0.01), and higher dynamic NRS values at 6 h postoperatively (OR [95% CI], 1.28 [1.05–1.55], p = 0.01) were all independent predictors for CPBS. Conclusions Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6 h postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation. Trial registration ClinicalTrials.gov registration NCT04309929.
Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods. Adult female patients scheduled for oncological or reconstructive breast surgery at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was evaluated at 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of CPBS was 28% [95%CI 23.1%-33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and higher dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for preexisting chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation.Trial registration: clinicalTrials.gov registration NCT04309929
Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods. Adult female patients scheduled for oncological or reconstructive breast surgery at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was evaluated at 2 months (“pain becoming chronic”) and at 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of “pain becoming chronic” was 25.4% [95%CI 20.6%-30.7%], while that of CPBS was 28% [95%CI 23.1%-33.4%]. The presence of pain at 2 months concords with the presence of CPBS at 3 months (Cohen k coefficient 0.63, IC95% 0.54-0.73). Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and higher dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. The presence of early pain at 2 months after surgery concords with the occurrence of CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicization. In our cohort, long-term use of analgesics for preexisting chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. Trial registration: clinicalTrials.gov registration NCT04309929
Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods. Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0hrs, 3hrs, 6hrs, 12hrs, 24hrs, 48hrs, and 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of CPBS was 28% [95%CI 23.1%-33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and higher dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation.Trial registration: clinicalTrials.gov registration NCT04309929
Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health conditions. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence of and the risk factors for CPBS. The aim of this prospective, observational study is to describe incidence of and risk factors for CPBS, defined in accordance with the IASP taskforce. The impact of CPBS on patients’ daily functions is also described. Methods. Adult female patients scheduled for oncological or reconstructive breast surgery at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Persistent postoperative pain was evaluated at 2 months (“pain becoming chronic”) and at 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of “pain becoming chronic” was 25.4% [95%CI 20.6%-30.7%], while that of CPBS was 28% [95%CI 23.1%-33.4%]. The presence of persistent pain at 2 months concords with the presence of CPBS at 3 months (Cohen k coefficient 0.63, IC95% 0.54-0.73). Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. The presence of an earlier form of persistent pain at 2 months after surgery concords with the occurrence of CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicization. In our cohort, long-term use of analgesics for preexisting chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. Trial registration: clinicalTrials.gov registration NCT04309929
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