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A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
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Published on: January 18, 2018

Acute and persistent postoperative pain after breast surgery.

Karamarie Fecho1, Natalie R Miller, Sarah A Merritt

  • 1Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7010, USA. kfecho@aims.unc.edu

Pain Medicine (Malden, Mass.)
|May 21, 2009
PubMed
Summary

Nearly 60% of breast surgery patients report severe acute pain after mastectomy. Persistent severe pain affects nearly 10% of patients up to 12 months post-surgery, with factors like race and obesity influencing outcomes.

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Area of Science:

  • Pain Management
  • Surgical Outcomes
  • Oncology

Background:

  • Postoperative pain is a significant concern following mastectomy.
  • Understanding acute and persistent pain is crucial for patient recovery.
  • Factors influencing pain severity require further investigation.

Purpose of the Study:

  • To determine acute and persistent postoperative pain levels after mastectomy.
  • To identify the incidence of severe postoperative pain.
  • To examine factors associated with postoperative pain.

Main Methods:

  • Retrospective cohort study of 196 female breast surgery patients.
  • Pain assessed using Numerical Rating Scale (NRS) in the Post Anesthesia Care Unit (PACU) and at 1, 6-12 months post-op.
  • Analysis included demographics, comorbidities, and opioid use; severe pain defined as NRS ≥ 5.

Main Results:

  • 57.7% experienced severe acute pain in the PACU, increasing with surgical complexity.
  • 22.1% had severe pain at 1 month, and 8.2% at 6-12 months.
  • Older age and hypertension linked to less PACU pain; non-White race, obesity, and high PACU opioid use associated with greater pain at 1 month and beyond.

Conclusions:

  • Almost 60% of mastectomy patients experience severe acute postoperative pain.
  • Severe pain persists for 6-12 months in nearly 10% of patients.
  • Factors like race, obesity, and opioid use influence long-term pain.