Pain in 1,000 Women Treated for Breast Cancer

Kaunisto, Mari A.; Jokela, R.; Tallgren, Minna; Kambur, Oleg; Tikkanen, Emmi; Tasmuth, Tiina; Sipilä, Reetta; Palotie, Aarno; Estlander, Ann-Mari; Leidenius, Marjut; Ripatti, Samuli; Kalso, Eija

doi:10.1097/aln.0000000000000012

Cited by 91 publications

(31 citation statements)

References 30 publications

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“…Also in a study conducted with 1000 women submitted to mastectomy, it was seen high levels of anxiety linked to the increase of experimental pain sensitivity and, also, to acute postoperative pain, contrary to Janis' theory [26]. …”

Section: Discussionmentioning

confidence: 99%

Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section

Borges

Pereira

Moura

et al. 2016

Pain Research and Management

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Background. Moderate to severe postoperative pain affects performance of daily activities and it contributes to persistent postoperative pain. In patients submitted to cesarean section, this pain can also interfere with women's ability to care for their babies, to effectively breastfeed, and to satisfactorily interact with their children. Factors influencing the pain perception during the immediate postoperative period have not been widely pursued. Objective. To investigate the incidence and predicting factors of postoperative pain after cesarean section. Methods. A prospective longitudinal study with 1,062 women submitted to cesarean section. We collected sociodemographic, clinical, surgical, and health behavior data. We used the 11-point Numerical Pain and the Hospital Anxiety and Depression Scales. We performed logistic analysis to identify predictors of moderate to severe postoperative pain. Results. The incidence of moderate-severe postoperative pain was 78.4% (CI: 95%: 75.9%–80.8%). The preoperative anxiety (OR = 1.60; CI 95%: 1.22–2.30) and intrathecal morphine with fentanyl (OR = 0,23; CI 95%: 0.08–0.66) were significantly associated with moderate-severe postoperative pain report. Conclusion. The preoperative anxiety increases the risk of moderate-severe postoperative pain in women submitted to cesarean section. The intrathecal morphine with fentanyl added to bupivacaine was a protective factor against this pain.

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Section: Discussionmentioning

confidence: 99%

Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section

Borges

Pereira

Moura

et al. 2016

Pain Research and Management

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“…The whole cohort of 1000 patients has been described in more detail earlier. 26 Oral and written consent was obtained from all patients. The Coordinating Ethics Committee of the Helsinki University Central Hospital approved the study protocol.…”

Section: Methodsmentioning

confidence: 99%

Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery

Sipilä

Haasio

Meretoja

et al. 2017

PAIN

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“…The study cohort is described in detail in the accompanying article. 22 In brief, either mastectomy or breast conserving surgery, with sentinel node biopsy, axillary clearance, or both, was performed. Before surgery, the patients filled in questionnaires on depression (Beck Depression Inventory) 23 and anxiety (State and Trait Anxiety Inventory), 24 and underwent experimental pain tests.…”

Section: Methodsmentioning

confidence: 99%

“…22 For the heat pain, the volar surface of the forearm was first exposed to 43°C for 5 s and then 48°C also for 5 s. The patients assessed the intensity and unpleasantness of pain with a 0–10 numerical rating scale (NRS) at the end of each test; zero represented “no pain,” and 10 “worst imaginable pain.” All 1,000 women were evaluated for heat pain sensitivity.…”

Section: Methodsmentioning

confidence: 99%

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Effect of Catechol-o-methyltransferase-gene (COMT) Variants on Experimental and Acute Postoperative Pain in 1,000 Women undergoing Surgery for Breast Cancer

et al. 2013

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Background Catechol-O-methyltransferase (COMT) metabolizes catecholamines in different tissues. Polymorphisms in COMT gene can attenuate COMT activity and increase sensitivity to pain. Human studies exploring the effect of COMT polymorphisms on pain sensitivity have mostly included small, heterogeneous samples and have ignored several important single nucleotide polymorphisms (SNPs). This study examines the effect of COMT polymorphisms on experimental and postoperative pain phenotypes in a large ethnically homogeneous female patient cohort. Methods Intensity of cold (+2–4°C) and heat (+48°C) pain and tolerance to cold pain were assessed in 1,000 patients scheduled for breast cancer surgery. Acute postoperative pain and oxycodone requirements were recorded. Twenty-two COMT SNPs were genotyped and their association with six pain phenotypes analyzed with linear regression. Results There was no association between any of the tested pain phenotypes and SNP rs4680. The strongest association signals were seen between rs165774 and heat pain intensity as well as rs887200 and cold pain intensity. In both cases, minor allele carriers reported less pain. Neither of these results remained significant after strict multiple testing corrections. When analyzed further, the effect of rs887200 was, however, shown to be significant and consistent throughout the cold pressure test. No evidence of association between the SNPs and postoperative oxycodone consumption was found. Conclusions SNPs rs887200 and rs165774 located in the untranslated regions of the gene had the strongest effects on pain sensitivity. Their effect on pain is described here for the first time. These results should be confirmed in further studies and the potential functional mechanisms of the variants studied.

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Pain in 1,000 Women Treated for Breast Cancer

Abstract: Contact heat and cold pressure tests identify variability in pain sensitivity which is modified by factors such as anxiety, chronic pain, previous surgery, and smoking. High levels of anxiety are connected to increased pain sensitivity in experimental and acute postoperative pain.

Cited by 91 publications

References 30 publications

Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section

Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section

Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery

Effect of Catechol-o-methyltransferase-gene (COMT) Variants on Experimental and Acute Postoperative Pain in 1,000 Women undergoing Surgery for Breast Cancer

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