BACKGROUND: In a previous randomized, triple-masked, placebo-controlled study, the authors demonstrated that extending a single-injection paravertebral nerve block with a multiple-day perineural local anesthetic infusion improves analgesia and decreases pain-related dysfunction during the 3-day infusion but not subsequent to catheter removal within 1 month after mastectomy. This report describes a prospective follow-up study of the previously published trial to investigate the possibility that extending a single-injection paravertebral block with a multiple-day infusion may decrease persistent postsurgical pain as well as pain-induced emotional and functional dysfunction 1 year after mastectomy. METHODS:Subjects undergoing uni- or bilateral mastectomy received unilateral (n = 24) or bilateral (n = 36) single-injection thoracic paravertebral block(s) with ropivacaine and perineural catheter(s). The subjects were randomized to receive either ropivacaine 0.4 % (n = 30) or normal saline (n = 30) via their catheters until the catheters were removed on postoperative day 3. Chronic pain and pain-related physical and emotional dysfunction were measured using the Brief Pain Inventory (BPI). RESULTS: No statistically significant difference between treatments 3 months after surgery was observed with the BPI. In contrast, after 12 months, only 4 subjects (13 %) who had received a perineural ropivacaine infusion reported pain-induced dysfunction compared with 14 (47 %) who had received saline infusion (P = 0.011). At 12 months, the mean BPI was 1.6 ± 4.6 for the subjects who received ropivacaine versus 5.9 ± 11.3 for the subjects who received saline (P = 0.007). CONCLUSIONS: Adding a multiple-day, continuous ropivacaine infusion to a single-injection ropivacaine paravertebral nerve block may result in a lower incidence of pain as well as pain-related physical and emotional dysfunction 1 year after mastectomy.
RCT Entities:
BACKGROUND: In a previous randomized, triple-masked, placebo-controlled study, the authors demonstrated that extending a single-injection paravertebral nerve block with a multiple-day perineural local anesthetic infusion improves analgesia and decreases pain-related dysfunction during the 3-day infusion but not subsequent to catheter removal within 1 month after mastectomy. This report describes a prospective follow-up study of the previously published trial to investigate the possibility that extending a single-injection paravertebral block with a multiple-day infusion may decrease persistent postsurgical pain as well as pain-induced emotional and functional dysfunction 1 year after mastectomy. METHODS: Subjects undergoing uni- or bilateral mastectomy received unilateral (n = 24) or bilateral (n = 36) single-injection thoracic paravertebral block(s) with ropivacaine and perineural catheter(s). The subjects were randomized to receive either ropivacaine 0.4 % (n = 30) or normal saline (n = 30) via their catheters until the catheters were removed on postoperative day 3. Chronic pain and pain-related physical and emotional dysfunction were measured using the Brief Pain Inventory (BPI). RESULTS: No statistically significant difference between treatments 3 months after surgery was observed with the BPI. In contrast, after 12 months, only 4 subjects (13 %) who had received a perineural ropivacaine infusion reported pain-induced dysfunction compared with 14 (47 %) who had received saline infusion (P = 0.011). At 12 months, the mean BPI was 1.6 ± 4.6 for the subjects who received ropivacaine versus 5.9 ± 11.3 for the subjects who received saline (P = 0.007). CONCLUSIONS: Adding a multiple-day, continuous ropivacaine infusion to a single-injection ropivacaineparavertebral nerve block may result in a lower incidence of pain as well as pain-related physical and emotional dysfunction 1 year after mastectomy.
Authors: Daphna M Finn; Brian M Ilfeld; Jonathan T Unkart; Sarah J Madison; Preetham J Suresh; Nav Parkash S Sandhu; Nicholas J Kormylo; Nisha Malhotra; Vanessa J Loland; Mark S Wallace; Cindy H Wen; Anya C Morgan; Anne M Wallace Journal: J Anesth Date: 2017-03-31 Impact factor: 2.078
Authors: Michael L Kent; Patrick J Tighe; Inna Belfer; Timothy J Brennan; Stephen Bruehl; Chad M Brummett; Chester C Buckenmaier; Asokumar Buvanendran; Robert I Cohen; Paul Desjardins; David Edwards; Roger Fillingim; Jennifer Gewandter; Debra B Gordon; Robert W Hurley; Henrik Kehlet; John D Loeser; Sean Mackey; Samuel A McLean; Rosemary Polomano; Siamak Rahman; Srinivasa Raja; Michael Rowbotham; Santhanam Suresh; Bernard Schachtel; Kristin Schreiber; Mark Schumacher; Brett Stacey; Steven Stanos; Knox Todd; Dennis C Turk; Steven J Weisman; Christopher Wu; Daniel B Carr; Robert H Dworkin; Gregory Terman Journal: J Pain Date: 2017-05 Impact factor: 5.820
Authors: Michael J Buys; Kimberlee Bayless; Jennifer Romesser; Zachary Anderson; Shardool Patel; Chong Zhang; Angela P Presson; Benjamin S Brooke Journal: Reg Anesth Pain Med Date: 2020-08-26 Impact factor: 6.288
Authors: Nantthasorn Zinboonyahgoon; Megan E Patton; Yun-Yun K Chen; Rob R Edwards; Kristin L Schreiber Journal: Pain Med Date: 2021-08-06 Impact factor: 3.750
Authors: Erica J Weinstein; Jacob L Levene; Marc S Cohen; Doerthe A Andreae; Jerry Y Chao; Matthew Johnson; Charles B Hall; Michael H Andreae Journal: Cochrane Database Syst Rev Date: 2018-06-20
Authors: Erica J Weinstein; Jacob L Levene; Marc S Cohen; Doerthe A Andreae; Jerry Y Chao; Matthew Johnson; Charles B Hall; Michael H Andreae Journal: Cochrane Database Syst Rev Date: 2018-04-25