C-reactive Protein Level on Postoperative Day One is Associated with Chronic Postsurgical Pain After Mastectomy

Abstract

BackgroundC-reactive protein (CRP) is an acute phase reactant released in response to inflammation or tissue injury. Inflammation is one of the pathogenic factors related to transition from acute postsurgical pain (APSP) to chronic postsurgical pain (CPSP). Although several risk factors are reportedly associated with CPSP, the effects of CRP levels on CPSP have not been examined.ObjectivesThe present study investigated the relationship between perioperative risk factors, including CRP levels on postoperative day one and CPSP, in patients undergoing mastectomy.MethodsPreoperative anxiety and depression levels were evaluated in female patients undergoing mastectomy under general anesthesia, with or without peripheral nerve block. Patients with chronic preoperative pain and/or preoperative breast pain were excluded. The intensity of postoperative pain was prospectively examined one and six days, and three and twelve months after surgery using a numerical rating scale (NRS).ResultsThe current researchers conducted univariate and multivariate linear regression analyses to explore risk factors for CPSP in 36 patients. Patient demographics, preoperative psychological states, and anesthetic managements showed no relationship with CPSP. On the other hand, pain intensity of APSP and CRP levels on postoperative day one was significantly associated with the pain intensity of CPSP.ConclusionsPostoperative CRP level is likely to be associated with the development of CPSP after mastectomy.

<p>A Conceptual Model of Biopsychosocial Mechanisms of Transition from Acute to Chronic Postsurgical Pain in Children and Adolescents</p>

“…Studies exploring risk factors for CPSP in adults have emphasized the influence of the inflammatory response on postoperative pain. Immune cells and inflammatory molecules have been cited as a possible factors involved in the transition from acute to chronic postsurgical pain, 74 , 75 and circulating markers such as the neutrophil to lymphocyte ratio and C-reactive protein have been associated with CPSP 76 , 77 in adults. In the acute postsurgical literature, a single available pediatric study did not find a relationship between preoperative salivary cortisol concentrations and acute postoperative pain.…”

The effects of pre‐emptive intravenous ibuprofen on the thiol/disulfide homeostasis and C‐reactive protein level as the markers of oxidative stress and inflammation during gynecologic laparoscopy: A randomised clinical trial

“…CRP is an acute‐phase reactant that reflects the response to inflammation or tissue damage. Recent studies showed that an increased level of postoperative CRP level was positively associated with increased acute postsurgical pain scores and analgesic requirement 21‐24 . CRP usually hits a peak level two or three days after surgery 25 .…”

“…Recent studies showed that an increased level of postoperative CRP level was positively associated with increased acute postsurgical pain scores and analgesic requirement. [21][22][23][24] CRP usually hits a peak level two or three days after surgery. 25 Contrary to the results of these studies, patients requiring rescue analgesia and the VAS scores in all assessment time points in ibuprofen treated patients were significantly lower than patients who received only IV paracetamol in our study.…”

Comparison of C-Reactive Protein, Cortisol and Interleukin-6 Dynamics After Breast Surgery Under General Anesthesia, or General Anesthesia in Combination With Pectoral Block, or General Anesthesia in Combination With Thoracic Paravertebral Block

“…Плазмовий рівень СRP зростає пропорційно до ступеня пошкодження тканин [18] і є маркером розвитку та інтенсивності хронічного болю після мастектомії [19]. Підвищення плазмового рівня Среактивного білка через 24 і 72 год після операції зв'язано із післяопераційними ускладненнями [20].…”