Background:Postmastectomy pain syndrome (PMPS) is defined as a chronic (continuing for 3 or more months) neuropathic pain affecting the axilla, medial arm, breast, and chest wall after breast cancer surgery. The prevalence of PMPS has been reported to range from 20% to 68%. In this study, we aimed to determine the prevalence of PMPS among mastectomy patients, the severity of neuropathic pain in these patients, risk factors that contribute to pain becoming chronic, and the effect of PMPS on life quality.Methods:This cross-sectional study was approved by the Sakarya University, Medical Faculty Ethical Council and included 146 patients ranging in age from 18 to 85 years who visited the pain clinic, general surgery clinic, and oncology clinic and had breast surgery between 2012 and 2014. Patients were divided into two groups according to whether they met PMPS criteria: pain at axilla, arm, shoulder, chest wall, scar tissue, or breast at least 3 months after breast surgery. All patients gave informed consent prior to entry into the study. Patient medical records were collected, and pain and quality of life were evaluated by the visual analog scale (VAS) for pain, a short form of the McGill Pain Questionnaire (SF-MPQ), douleur neuropathique-4 (DN-4), and SF-36.Results:Patient mean age was 55.2 ± 11.8 years (33.0–83.0 years). PMPS prevalence was 36%. Mean scores on the VAS, SF-MPQ, and DN-4 in PMPS patients were 1.76 ± 2.38 (0–10), 1.73 ± 1.54 (0–5), and 1.64 ± 2.31 (0–8), respectively. Of these patients, 31 (23.7%) had neuropathic pain characteristics, and 12 (9.2%) had phantom pain according to the DN-4 survey. Patients who had modified radical mastectomy were significantly more likely to develop PMPS than patients who had breast-protective surgery (P = 0.028). Only 2 (2.4%) of PMPS patients had received proper treatment (anticonvulsants or opioids).Conclusions:PMPS seriously impacts patients’ emotional situation, daily activities, and social relationships and is a major economic burden for health systems. We conclude that the rate of PMPS among patients receiving breast cancer surgery in Turkey is 64.1% and that challenges to the proper treatment of these patients deserve further investigation.

The coronavirus disease 2019 (COVID-19) can be responsible for severe acute respiratory syndrome and death. To limit the infection spread, non-urgent surgical procedures, day procedures, including interventional pain management, and patient visits, have been postponed or interrupted during the COVID-19 pandemic. Pain management is defined as a fundamental human right, but the rapidly changing nature of the COVID-19 outbreak requires revisions in clinical practice for chronic pain. This article describes the role of home healthcare services in managing cancer pain based on clinical practice during the COVID-19 pandemic and emphasizes the triple triage concept and the use of telemedicine. Key words: Coronavirus; COVID-19; Telemedicine; Home care; Cancer Pain Citation: Ergönenç T, Ergönenç JS, Altınpulluk EY. The role of home healthcare in managing cancer-related pain during COVID-19 pandemic: ‘The Triple Triage Protocol’. Snaesth. Pain intensive care 2021;25(1):1-4. DOI: 10.35975/apic.v25i1.1430 Received: 4 January 2021, Reviewed & Accepted:  8 January 2021

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The COVID-19 pandemic has made it difficult for patients to receive palliative care and home health services (HHS) in several ways. First, the pandemic has led to a shortage of healthcare workers, making it challenging to care for patients in hospitals and the community. Second, the pandemic has caused social distancing measures, making it difficult for patients to receive in-person care from healthcare providers. Third, the pandemic has led to a fear of infection, causing some patients and caregivers to be reluctant to seek care.Despite these challenges, ensuring that patients with serious illnesses continue receiving the care they need is essential. Palliative care can help to improve the quality of life for patients and their families, and HHS can help to ensure that patients can live independently and safely in their own homes.