Risk factors for acute pain and its persistence following breast cancer surgery

Abstract

Although more severe acute postoperative pain increases the risk of chronic pain following breast cancer surgery, few studies have examined the characteristics of patients who develop greater acute pain. To identify risk factors for acute pain and its persistence one month following breast cancer surgery, a sample of 114 women scheduled for breast cancer surgery was assessed preoperatively for demographic, clinical, and emotional functioning variables that were hypothesized to be associated with acute pain severity. Clinically meaningful postoperative pain was assessed at follow-up interviews 2, 10, and 30 days after surgery. In univariate analyses, the risk of clinically meaningful acute pain was increased among women who were younger, unmarried, had more invasive surgeries, and had greater preoperative emotional distress. In multiple logistic regression analyses, greater preoperative anxiety was the only variable that made an independent contribution to predicting clinically meaningful acute pain at 2 days after surgery whereas younger age, being unmarried, and preoperative anxiety each made an independent contribution to predicting clinically meaningful acute pain that persisted from 2 to 30 days after surgery. These results increase understanding of neurobiologic mechanisms and psychosocial processes that contribute to the development of acute pain following breast cancer surgery and have implications for the development of interventions to prevent it.

Transitional Pain Medicine: novel pharmacological treatments for the management of moderate to severe postsurgical pain

“…[1] Opioid-naïve patients that have moderate to severe acute postoperative pain, [15] increased perioperative opioid use [16], preoperative negative affective states such as posttraumatic stress disorder, [17] depression, [18,19] anxiety, [7,20,21] and pain catastrophizing [22,23] are all candidates for our TPS given their increased risk to develop persistent pain and pain disability as a consequence of their surgical intervention.…”

Anything Other than Pain that Matters after Breast Cancer Surgery? A Randomized Controlled Study Comparing Three Anesthetic Modalities

“…There could be multiple causes. Although there were no statistical differences among the three groups in surgical types or operation duration, PVB group had the largest proportion of patients with ALND, in which intercostal nerve injury is more likely than in SLND [16]. Secondly, longer operation duration in PVB group, although without statistical significance, implied inherently more extensive procedure albeit under randomization.…”

“…Preoperative anxiety makes an independent contribution to predicting acute pain after breast surgery [16]. To have this variable controlled, all patients were evaluated preoperatively with a validated questionnaire, the Hospital Anxiety and Depression Scale [17].…”

Preserving of intercostobrachial nerve relieves breast carcinoma patients from postmastectomy pain syndrome

“…A benefit of preservation of the ICB nerve has been reported in several descriptive studies and includes a reduction in postoperative pain, improved sensation and reduced arm stiffness. 24,[28][29][30] The course of the nerve is important for the surgeon. Cunnick et al described that the anatomy of the ICB nerve in the axilla is highly variable.…”