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A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
Non-Pharmacological Interventions for Postoperative Pain in Breast Cancer Patients: A Network Meta-analysis
Yuanyuan Wang1, Jiawei Song2, Huiling Zhang3
1School of Medicine, Bozhou Vocational and Technical College, Bozhou, China; College of Nursing and Allied Health Sciences, St. Paul University Manila, Manila, Philippines.
Summary
Combined non-pharmacological therapies, like psychological support with exercise or physical therapy, are most effective for managing breast cancer patients' postoperative pain and anxiety. These approaches offer significant benefits over conventional treatments.
Area of Science:
- Oncology
- Pain Management
- Rehabilitation Medicine
Background:
- Breast cancer (BC) surgery often results in significant postoperative pain, impacting patient recovery and quality of life.
- While pharmacological methods are standard, their side effects drive interest in non-pharmacological interventions.
- Comparative data on the efficacy of various non-drug strategies for BC postoperative pain is limited.
Purpose of the Study:
- To systematically evaluate and compare the effectiveness of diverse non-pharmacological interventions for managing postoperative pain in breast cancer patients.
- To conduct a network meta-analysis to synthesize evidence from randomized controlled trials (RCTs).
Main Methods:
- Systematic review and network meta-analysis of RCTs identified through a comprehensive search of multiple English and Chinese databases up to December 2024.
- Primary outcomes included pain scores, anxiety levels, upper limb function, and pain control effectiveness rate.
- Methodological quality was assessed using the Cochrane Risk of Bias tool; network meta-analysis performed using Stata 16.0 with Surface Under the Cumulative Ranking Curve (SUCRA) for ranking interventions.
Main Results:
- Thirty studies with 2,256 patients and 10 intervention types were analyzed; no significant adverse events were reported.
- Psychological + Exercise therapy showed the highest efficacy for pain relief (SUCRA=96.5), followed by Psychological + Physical therapy (SUCRA=92.0).
- Psychological + Physical therapy was most effective for anxiety reduction (SUCRA=99.2), and Exercise + Traditional Chinese Medicine improved upper limb function (SUCRA=80.6).
Conclusions:
- Combined non-pharmacological interventions, particularly Psychological + Exercise therapy and Psychological + Physical therapy, are more effective than single modalities for postoperative pain in breast cancer patients.
- Psychological + Physical therapy also demonstrated significant benefits in reducing anxiety.
- Findings suggest evidence-based support for these combined approaches, though caution is advised due to study limitations.
