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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.
Purpose:
Breast cancer (BC) is the most prevalent malignancy among women, with surgical resection remaining the cornerstone of treatment. Postoperative pain is a common and significant complication that adversely affects recovery and quality of life. Although pharmacological treatments are widely utilized, their potential adverse effects have led to growing interest in non-pharmacological interventions as complementary approaches. However, there is a lack of comparative evidence regarding the effectiveness of these various non-drug strategies.This study aimed to systematically evaluate and compare the efficacy of different non-pharmacological interventions for managing postoperative pain in patients with BC using a network meta-analysis.
Design:
A systematic review and network meta-analysis of randomized controlled trials (RCTs).
Methods:
A comprehensive search was conducted across English and Chinese databases, including PubMed, Web of Science, Scopus, MEDLINE, ProQuest, Embase, the Cochrane Library, CNKI, Wanfang, and SinoMed, to identify randomized controlled trials (RCTs) evaluating non-pharmacological interventions for postoperative pain in BC patients. The search included studies published up to December 2024. Primary outcomes included pain scores, anxiety scores, upper limb function, and the effectiveness rate of pain control. Methodological quality was assessed using the Cochrane Risk of Bias tool. A network meta-analysis was conducted using Stata 16.0, and the surface under the cumulative ranking curve (SUCRA) was used to determine the relative effectiveness of interventions. The study was registered in PROSPERO (CRD42024586943).
Results:
A total of 30 studies involving 2,256 patients and 10 types of non-pharmacological interventions were included. No significant adverse events were reported. Network meta-analysis revealed that Psychological + Exercise therapy was the most effective for pain relief (vs. Conventional therapy: SMD = 3.91, 95% CI [2.21, 5.61]; SUCRA = 96.5), followed by Psychological + Physical therapy (SMD = 3.40, 95% CI [1.13, 5.67]; SUCRA = 92.0). For anxiety reduction, Psychological + Physical therapy demonstrated the greatest benefit (SMD = 3.11, 95% CI [1.29, 4.93]; SUCRA = 99.2). For upper limb function recovery, Exercise + Traditional Chinese Medicine showed significant improvement (SMD = 0.95, 95% CI [0.13, 1.77]; SUCRA = 80.6).
Conclusions:
Combined non-pharmacological interventions appear to be more effective than single approaches in managing postoperative pain in BC patients. Specifically, Psychological + Exercise therapy and Psychological + Physical therapy yielded the most favorable outcomes. Psychological + Physical therapy also offered substantial benefits for alleviating anxiety, suggesting its broader clinical value. Nevertheless, due to the limited number and quality of included studies, these findings should be interpreted with caution.
Clinical Implications:
This study provides evidence-based support for the use of non-pharmacological interventions in the postoperative management of breast cancer and may inform future clinical practice and research.
