OBJECTIVES: Persistent postsurgical pain (PPSP) after surgery for breast cancer has a prevalence of 20% to 52%. Neuroplastic changes may play a role in the aetiology of this pain. The principal objective of this study was to examine the relationship between acute pain after surgery for breast cancer and the likelihood of subsequently developing PPSP. METHODS: Twenty-eight women undergoing surgery for breast cancer completed visual analogue scales for pain and anxiety, the McGill Pain Questionnaire (long form) and the Hospital Anxiety and Depression Scale. Analgesic requirements and adverse effects of analgesic therapy were noted. Quantitative sensory testing was carried out perioperatively using an electrical stimulus, and the sensation perception, pain perception, and pain tolerance thresholds were measured bilaterally at the T4 dermatomes and at the contralateral L5 dermatome. Patients with and without PPSP 3 months postoperatively were compared in terms of these parameters. RESULTS: Eight participants (28.6%) reported PPSP. Those who subsequently developed PPSP reported greater pain scores on the McGill Pain Questionnaire 5 days postoperatively than those that did not (pain rating index, P=0.014; present pain intensity, P=0.032). None had sought medical attention for their persistent pain. Patients with and without PPSP were similar in terms of mental status (anxiety and depression), analgesic consumption, adverse effects of analgesic therapy, and changes on QST. DISCUSSION: Patients who developed PPSP experienced pain of greater intensity on the fifth postoperative day than those that did not.
OBJECTIVES: Persistent postsurgical pain (PPSP) after surgery for breast cancer has a prevalence of 20% to 52%. Neuroplastic changes may play a role in the aetiology of this pain. The principal objective of this study was to examine the relationship between acute pain after surgery for breast cancer and the likelihood of subsequently developing PPSP. METHODS: Twenty-eight women undergoing surgery for breast cancer completed visual analogue scales for pain and anxiety, the McGill Pain Questionnaire (long form) and the Hospital Anxiety and Depression Scale. Analgesic requirements and adverse effects of analgesic therapy were noted. Quantitative sensory testing was carried out perioperatively using an electrical stimulus, and the sensation perception, pain perception, and pain tolerance thresholds were measured bilaterally at the T4 dermatomes and at the contralateral L5 dermatome. Patients with and without PPSP 3 months postoperatively were compared in terms of these parameters. RESULTS: Eight participants (28.6%) reported PPSP. Those who subsequently developed PPSP reported greater pain scores on the McGill Pain Questionnaire 5 days postoperatively than those that did not (pain rating index, P=0.014; present pain intensity, P=0.032). None had sought medical attention for their persistent pain. Patients with and without PPSP were similar in terms of mental status (anxiety and depression), analgesic consumption, adverse effects of analgesic therapy, and changes on QST. DISCUSSION: Patients who developed PPSP experienced pain of greater intensity on the fifth postoperative day than those that did not.
Authors: Ian R Carroll; Jennifer M Hah; Peter L Barelka; Charlie K M Wang; Bing M Wang; Matthew J Gillespie; Rebecca McCue; Jarred W Younger; Jodie Trafton; Keith Humphreys; Stuart B Goodman; Fredrick M Dirbas; Sean C Mackey Journal: Pain Med Date: 2015-07-14 Impact factor: 3.750
Authors: Sara N Edmond; Rebecca A Shelby; Francis J Keefe; Hannah M Fisher; John E Schmidt; Mary S Soo; Celette S Skinner; Gretchen M Ahrendt; Jessica Manculich; Jules H Sumkin; Margarita L Zuley; Dana H Bovbjerg Journal: Clin J Pain Date: 2017-01 Impact factor: 3.442
Authors: Birha McCann; Christine Miaskowski; Theresa Koetters; Christina Baggott; Claudia West; Jon D Levine; Charles Elboim; Gary Abrams; Deborah Hamolsky; Laura Dunn; Hope Rugo; Marylin Dodd; Steven M Paul; John Neuhaus; Bruce Cooper; Brian Schmidt; Dale Langford; Janine Cataldo; Bradley E Aouizerat Journal: J Pain Date: 2012-04-18 Impact factor: 5.820
Authors: Patrick James Tighe; Christopher A Harle; Andre Pierre Boezaart; Haldun Aytug; Roger Fillingim Journal: Pain Med Date: 2013-12-05 Impact factor: 3.750
Authors: Noud van Helmond; Monique A Steegers; Gertie P Filippini-de Moor; Kris C Vissers; Oliver H Wilder-Smith Journal: PLoS One Date: 2016-12-09 Impact factor: 3.240