General anaesthetic agents do not influence persistent pain after breast cancer surgery

Lefebvre-Kuntz, Danièle; Dualé, Christian; Albi-Feldzer, Aline; Nougarède, B.; Falewee, M. N.; Ouchchane, Lemlih; Soule-Sonneville, Sylvie; Bonneau, Julie; Dubray, Claude; Schoeffler, P.

doi:10.1097/eja.0000000000000215

Cited by 6 publications

(2 citation statements)

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“…with a greater sample size found no difference between propofol and other halogenated agent anesthetics. 32 Neither study found an effect of anesthesia type on pain intensity.…”

Section: Resultsmentioning

confidence: 93%

“…Ten studies on the efficacy of anesthesia in the prevention of PMPS met inclusion criteria ( Table 4 ). 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 These included one retrospective study, one prospective study, and eight double-blinded RCTs. The mean follow-up time for all ten studies was 9 months, and the total study population was 1287 patients.…”

Section: Resultsmentioning

confidence: 99%

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“Post Mastectomy Pain Syndrome: A Systematic Review of Prevention Modalities”

et al. 2022

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SUMMARY Background Post-mastectomy pain syndrome (PMPS) is a surgical complication of breast surgery characterized by chronic neuropathic pain. The development of PMPS is multifactorial and research on its prevention is limited. The objective of this systematic review is to synthesize the existing evidence on interventions for lowering the incidence of persistent neuropathic pain after breast surgery. Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a comprehensive search of the electronic databases of MEDLINE, Cochrane Library, Embase, CINAHL, PsycINFO, Web of Science, and ClinicalTrials.gov using a combination of database-specific controlled vocabulary and keyword searches. Two reviewers independently screened all unique records. Publications on chronic (>3-month duration) pain after breast cancer-related surgery were included. Studies were classified by modality. Results Our literature search yielded 7092 articles after deduplication. We identified 45 studies that met final inclusion criteria for analysis, including 37 randomized-controlled trials. These studies revealed seven major intervention modalities for prevention of PMPS: physical therapy, mindfulness-based cognitive therapy, oral medications, surgical intervention, anesthesia, nerve blocks, and topical medication therapy. Conclusion High-quality data on preventative techniques for PMPS are required to inform decisions for breast cancer survivors. We present a comprehensive assessment of the modalities available that can help guide breast and reconstructive surgeons employ effective strategies to lower the incidence and severity of PMPS. Our review supports the use of multimodal care involving both a peripherally targeted treatment and centrally acting medication to prevent the development of PMPS.

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“…with a greater sample size found no difference between propofol and other halogenated agent anesthetics. 32 Neither study found an effect of anesthesia type on pain intensity.…”

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

“Post Mastectomy Pain Syndrome: A Systematic Review of Prevention Modalities”

et al. 2022

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Prevention and Treatment of Chronic Postsurgical Pain: A Narrative Review

Steyaert

Lavand’homme

2018

Drugs

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Chronic postsurgical pain affects between 5 and 75% of patients, often with an adverse impact on quality of life. While the transition of acute to chronic pain is a complex process-involving multiple mechanisms at different levels-the current strategies for prevention have primarily been restricted to perioperative pharmacological interventions. In the present paper, we first present an up-to-date narrative literature review of these interventions. In the second section, we develop several ways by which we could overcome the limitations of the current approaches and enhance the outcome of our surgical patients, including the better identification of individual risk factors, tailoring treatment to individual patients, and improved acute and subacute pain evaluation and management. The third and final section covers the treatment of established CPSP. Given that evidence for the current therapeutic options is limited, we need high-quality trials studying multimodal interventions matched to pain characteristics.

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