Régis Fuzier1, Floriane Puel2, Philippe Izard2, Agnès Sommet3, Sébastien Pierre2. 1. Department of Anesthesiology, Institut Claudius Regaud. University Institute of Cancer Toulouse Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse Cedex, France. fuzier.r@gmail.com. 2. Department of Anesthesiology, Institut Claudius Regaud. University Institute of Cancer Toulouse Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse Cedex, France. 3. Pharmacoepidemiology Research Unit, INSERM 1027, University of Toulouse, Toulouse, France.
Abstract
PURPOSE: Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer. METHODS: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period. Three months after the surgery, a questionnaire was sent to the patients with a pre-stamped envelope for return. The questions probed responses required to calculate a Brief Pain Inventory score and modified neuropathic pain score (DN3). RESULTS: Over a 5-month period, 150 patients (aged 60 (11) years, body mass index of 25 (6) kg/m2) were included in the final analysis. In the recovery room, 43% of patients required morphine at a mean dose of 5.2 (1.8) mg. Three months post surgery, 60 patients (40%) reported persistent pain for which 62% took analgesic drugs. We found no risk factor associated with this persistent pain among our studied population. Neuropathic pain was noted in 61% of patients who reported persistent pain primarily associated with periareolar incision. CONCLUSIONS: Pain persisted up to three months after minor surgery for breast cancer in 40% of patients with mostly a neuropathic component (61%).
PURPOSE:Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer. METHODS: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period. Three months after the surgery, a questionnaire was sent to the patients with a pre-stamped envelope for return. The questions probed responses required to calculate a Brief Pain Inventory score and modified neuropathic pain score (DN3). RESULTS: Over a 5-month period, 150 patients (aged 60 (11) years, body mass index of 25 (6) kg/m2) were included in the final analysis. In the recovery room, 43% of patients required morphine at a mean dose of 5.2 (1.8) mg. Three months post surgery, 60 patients (40%) reported persistent pain for which 62% took analgesic drugs. We found no risk factor associated with this persistent pain among our studied population. Neuropathic pain was noted in 61% of patients who reported persistent pain primarily associated with periareolar incision. CONCLUSIONS:Pain persisted up to three months after minor surgery for breast cancer in 40% of patients with mostly a neuropathic component (61%).
Entities:
Keywords:
Cancer pain; Chronic pain; Neuropathic pain
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