Details

Autor(en) / Beteiligte

• Steyaert, Arnaud, MD
• Forget, Patrice, MD, PhD
• Dubois, Virginie, MD
• Lavand'homme, Patricia, MD, PhD
• De Kock, Marc, MD, PhD

Titel

Does the perioperative analgesic/anesthetic regimen influence the prevalence of long-term chronic pain after mastectomy?

Ist Teil von

• Journal of clinical anesthesia, 2016-09, Vol.33, p.20-25

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Study Objective To investigate if the anesthetic/analgesic regimen is associated with the risk of reporting long-term chronic postmastectomy pain (CPMP). Design Cross-sectional survey Setting Academic hospital Patients A total of 267 women having undergone mastectomy with axillary lymph node dissection between 2003 and 2008 Interventions All patients were contacted between October and December 2012, with a questionnaire asking for persistent pain after surgery and its characteristics. Measurements Besides demographical data, tumor characteristics, and adjuvant treatment, we recorded type and doses of intraoperative anesthetics/analgesics (sufentanil, ketamine, clonidine, nonsteroidal anti-inflammatory drugs, MgSO4 , propofol, or halogenated agents). Results Of the 128 patients returning analyzable questionnaires, 43.8% reported chronic pain (48.2% with neuropathic characteristics). Multivariate logistic/linear regression model showed 4 factors independently associated with persistent pain: recall of preoperative pain (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.09-1.48), chemotherapy (OR, 1.32; 95% CI, 1.13-1.55), need for strong opioids in postanesthesia care unit (OR, 1.30; 95% CI, 1.11-1.53), and halogenated agent anesthesia (OR, 0.81; 95% CI, 0.70-0.95). Conclusion In conclusion, our study confirms the high prevalence of CPMP, 4 to 9 years after surgery. Recall of preoperative pain, chemotherapy, and need for strong opioids in the postanesthesia care unit were all associated with the presence of chronic pain. Of the intraoperative analgesics/anesthetics studied, only use of halogenated agents was associated with a lower prevalence of CPMP.