Perception of pain and influences on opioid use in implant‐based breast reconstruction patients

Abstract

Receiving a breast cancer diagnosis is a life-changing experience, and the need to undergo a mastectomy can generate many emotions. Hopelessness, ambivalence, body image disturbance, depression, and anxiety can result. 1,2 Preoperative psychological state and comorbidities may affect postoperative pain control and opioid use. Preoperative psychiatric comorbidities have been linked to increased acute postoperative pain following breast cancer surgery. 3,4 A history of depression or anxiety has also been shown to predict higher opioid consumption postoperatively. 5 Furthermore, these comorbidities can lead to long-term postoperative consequences of chronic surgical site pain and persistent opioid use. 6,7 In addition to psychiatric comorbidities, preoperative pain levels have also been found to predict more severe postoperative pain in breast cancer patients. 4,8 The severity of pain can also be predicted by coping

Surgery patients’ perspectives of their role in postoperative pain: A scoping review

“…These findings highlighted the fact that misconceptions can develop through various mechanisms and serve as barriers to effective pain management ( Cogan et al., 2017 ). Similar findings were noted in several studies that examined patients’ fears of addiction and other perceived opioid-related risks, such as nausea, vomiting, and drowsiness ( Angelini et al., 2018 ; Bjørnnes et al., 2017 ; Egan et al., 2020 ; Milosevic et al., 2021 ; Ramia et al., 2017a ; Tawil et al., 2018 ; van Dijk et al., 2015 ).…”

“…(2021) , Denmark Understand patient satisfaction with the erector spinae block for pain control Individuals undergoing general surgery, not differentiated. N = 11, (4 males, 7 females) Phenomenological semi- structured interviews, with thematic analysis Themes identified from interviews Expectations led to anxiety around pain Pain impacts all aspects of life Information helped decrease anxiety and improve perceived control Egan et al. (2020) , USA Evaluate perception and experience of pain in patients undergoing mastectomy and reconstruction Individuals undergoing reconstructive breast surgery.…”

“…Prior experience with post-operative pain has been shown to influence future reactions to painful stimuli ( Accardi-Ravid et al., 2020 ; Angelini et al., 2018 ; Dagyaran et al., 2021 ; Egan et al., 2020 ; Henningsen et al., 2018 ). This association is concerning, as many surgical patients experience under-managed pain ( Willingham et al., 2021 ).…”

“…High levels of pain in post-operative patients have been reported to contribute to negative expectations and anxiety ( Dagyaran et al., 2021 ; Henningsen et al., 2018 ; Köse Tamer and Sucu Dağ, 2020 ). For example, patients who had expectations of high pain intensity or inadequate relief due to prior pain experiences were five times more likely to report increased anxiety when compared to patients whose pain was previously well-managed ( Egan et al., 2020 ). Another study of patients undergoing hemicolectomy surgery found that the expectation of a poor prognosis, in addition to anticipated post-operative pain, produced significant worry amongst patients ( Dagyaran et al., 2021 ).…”