Chronic Breast Pain Prior to Breast Cancer Surgery Is Associated with Worse Acute Postoperative Pain Outcomes

Raza, Marium M.; Zaslansky, Ruth; Gordon, Debra B.; Wildisen, Jeanne M.; Komann, Marcus; Stamer, Ulrike; Langford, Dale J.

doi:10.3390/jcm10091887

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…Apart from the aforementioned direct adverse effects of opioid administration, the actual long-term clinical impact of decreased opioid consumption in the postoperative breast surgery setting remains a matter of debate. However, effective perioperative pain management is quintessential, as inadequate pain control can predicate chronic pain development [20][21][22]. Therefore, better chronic postoperative pain management can potentially mitigate the global opioid crisis by reducing the dependence on and over-prescription of opioids, which have been a major contributing factor to opioid misuse and overdose deaths.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Pectoral Nerve-2 Block (PECS 2) in Breast Cancer Surgery

Cylwik,

Celińska-Spodar,

Buda

2023

JPM

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This study aimed to evaluate the efficacy of the pectoral nerves interfacial plane block (PECS II) in breast cancer surgery focusing on postoperative pain management and patient satisfaction. A prospective study was conducted, including 200 patients scheduled for breast cancer surgery. The participants were randomly assigned to the PECS II block and control groups. The PECS II block group received a preoperative interfascial plane block, while the control group received standard analgesia. Postoperative pain scores at 4 h intervals for the first 3 postoperative days, as well as opioid consumption and patient-reported satisfaction, were measured and compared between both groups. The PECS II block group demonstrated significantly lower postoperative pain scores at all measured time points (p < 0.001). Additionally, the PECS II block group showed reduced opioid consumption (p < 0.001), reported higher levels of patient satisfaction compared to the control group, and had a notably shorter stay in the postoperative care unit (p < 0.001). Integrating the PECS block with general anesthesia in breast cancer surgeries enhances pain management, reduces opioid use, and shorten postanesthesia care unit stay. The evident benefits suggest PECS as a potential standard in breast surgeries. Future research should further investigate its long-term impacts and broader applications.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Pectoral Nerve-2 Block (PECS 2) in Breast Cancer Surgery

Cylwik,

Celińska-Spodar,

Buda

2023

JPM

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“…Raza et al 21 examined the impact of preexisting chronic breast pain on the acute postoperative experiences of women undergoing breast cancer surgery. Patients were grouped based on chronic pain status: without preexisting pain, with chronic pain elsewhere, and with chronic breast pain.…”

Section: The Impact Of the Preexisting Painmentioning

confidence: 99%

“…The majority of the past investigations have focused on healthy subjects and their physiological response to external pain stimuli 5,10,12,13 . A few studies have investigated different patient populations, such as chronic pain patients (primarily suffering from back pain and shoulder pain) 7,[14][15][16] , post-surgery patients 17 , injured patients 18 , orthopedic trauma patients 19 , musculoskeletal trauma patients 20 , and cancer patients (e.g., breast 21 ). While these studies have provided valuable insights, they did not explicitly consider the influence of preexisting pain.…”

Section: Introductionmentioning

confidence: 99%

Study of Influence of Preexisting Pain on the Body's Response to External Pain Stimuli

Ozek,

Lu,

Radhakrishnan

et al. 2024

Preprint

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The assessment of pain severity is essential for effective pain treatment. In clinical settings, pain intensity assessment relies on self-reporting methods, which are subjective to individuals and impractical for non-communicative or critically ill patients. In literature, there have been numerous attempts to objectively measure pain. In these studies, participants experience only one source of pain, which is not always the case in patients' medical conditions. In this study, our objective is to investigate the hypothesis that an individual's physiological response to external pain differs depending on experiencing preexisting pain. The underlying premise is that the body may exhibit different physiological responses to an external pain stimulus, depending on the intensity of the preexisting pain. To assess this hypothesis, we recruited 39 healthy subjects aged 22-37; among them, 23 were female, and 16 were male. Physiological signals - Electrodermal Activity and Electromyography - were recorded while participants underwent a combination of heat pain and cold stimuli. Through statistical analysis, we confirmed the hypothesis that the body exhibits different physiological responses to an external pain stimulus when influenced by preexisting pain. We identified key features of physiological signals (e.g., statistics and distributions) that significantly differ in response to new pain stimuli.

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“…Journal of Pain Research 2024:17 1796 studies, one cross-section study, and one retrospective study have reported that preoperative chronic pain history independently predicts moderate-or-severe APSP. 27,29,69,70 According to Raza et al, 71 the independent predictor of APSP intensity after breast cancer surgery was preexisting chronic pain in the breast (β 1.00, 95% CI 0.58-1.44), not elsewhere (β 0.08, 95% CI −0.23 to 0.39). However, past surgery-related pain and -unrelated pain both are related to APSP intensity after general, thoracic, and gynecological surgeries.…”

Section: Dovepressmentioning

confidence: 99%

Risk Factors for Acute Postsurgical Pain: A Narrative Review

Liu,

Dai,

et al. 2024

JPR

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Acute postsurgical pain (APSP) has received growing attention as a surgical outcome. When poorly controlled, APSP can affect short-and long-term outcomes in patients. Despite the steady increase in awareness about postoperative pain and standardization of pain prevention and treatment strategies, moderate-to-severe APSP is frequently reported in clinical practice. This is possibly because pain varies widely among individuals and is influenced by distinct factors, such as demographic, perioperative, psychological, and genetic factors. This review investigates the risk factors for APSP, including gender, age, obesity, smoking history, preoperative pain history, pain sensitivity, preoperative anxiety, depression, pain catastrophizing, expected postoperative pain, surgical fear, and genetic polymorphisms. By identifying patients having an increased risk of moderate-to-severe APSP at an early stage, clinicians can more effectively manage individualized analgesic treatment protocols with a combination of pharmacological and nonpharmacological interventions. This would alleviate the transition from APSP to chronic pain and reduce the severity of APSPinduced chronic physical disability and social psychological distress. Keywords: acute postoperative pain, acute postsurgical pain, risk factors, predictors which 86% reported moderate, severe, or extreme pain. 8 When poorly controlled, APSP can prolong hospital stay, increase opioid use, and contribute to health care costs. 9,10 Additionally, APSP is correlated with poor prognosis including postoperative delirium, cardiovascular events, thromboembolism, pulmonary complications, and chronic pain syndrome. [11][12][13][14][15] Although the interest in APSP is growing in the recent decades, effective pain management is a clinical challenge. 8,16 Identifying patients with high APSP-related risk factors on the basis of individual differences in patients' social, psychological, and genetic factors is essential for the early prevention and individualized treatment of APSP.APSP-related risk factors vary according to the surgery type. Ip et al 17 were the first to systematically review APSP predictors. They found that preoperative pain, anxiety, age, and surgery type were the four most significant predictors of APSP. Sobol-Kwapinska et al 18 reviewed APSP-related psychological factors and noted the probable association between APSP and anxiety, pain catastrophizing, expectation of pain, and depression. On conducting a systematic review of literature on pain sensitivity for predicting APSP, Werner et al 19 observed that the predictive strength of pain sensitivity is

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Chronic Breast Pain Prior to Breast Cancer Surgery Is Associated with Worse Acute Postoperative Pain Outcomes

Cited by 5 publications

References 34 publications

Evaluation of the Efficacy of Pectoral Nerve-2 Block (PECS 2) in Breast Cancer Surgery

Evaluation of the Efficacy of Pectoral Nerve-2 Block (PECS 2) in Breast Cancer Surgery

Study of Influence of Preexisting Pain on the Body's Response to External Pain Stimuli

Risk Factors for Acute Postsurgical Pain: A Narrative Review

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