Abstract
BACKGROUND AND OBJECTIVES: There are few prospective studies providing comprehensive assessment of risk factors for acute and persistent pain after breast surgery. This prospective observational study assessed patient-related, perioperative, and genetic risk factors for severe acute pain and persistent pain following breast cancer surgery. METHODS: Women presenting for elective breast cancer surgery completed State Trait Anxiety Inventory, Beck Depression Inventory, and Pain Catastrophizing Scale questionnaires preoperatively. Diffuse noxious inhibitory control and mechanical temporal summation were assessed. A blood sample was obtained for genetic analysis. Analgesic consumption and pain scores were collected in the post-anesthesia care unit, and at 24 and 72 hours. Patients were contacted at 1, 3, 6, and 12 months to assess persistent pain. Primary outcome was maximum acute pain score in first 72 hours and secondary outcome was persistent pain. RESULTS: One hundred twenty-four patients were included in analysis. Increased duration of surgery, surgeon, and higher pain catastrophizing scores were associated with increased severity of acute pain, while preoperative radiotherapy was associated with reduced severity. Persistent pain was reported by 57.3% of patients. Postdischarge chemotherapy (OR 2.52, 95% CI 1.13 to 5.82), postdischarge radiation (OR 3.39, 95% CI 1.24 to 10.41), severe acute pain (OR 5.39, 95% CI 2.03 to 15.54), and moderate acute pain (OR 5.31, 95% CI 1.99 to 15.30) were associated with increased likelihood of persistent pain. CONCLUSIONS: Increased duration of surgery, higher pain catastrophizing score, and surgeon were associated with increased severity of acute pain. Preoperative radiation was associated with lower acute pain scores. Postsurgery radiation, chemotherapy, and severity of acute pain were associated with increased likelihood of persistent pain. TRIAL REGISTRATION: NCT03307525.
| Original language | English |
|---|---|
| Pages (from-to) | 192-199 |
| Number of pages | 8 |
| Journal | Regional Anesthesia and Pain Medicine |
| Volume | 44 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - febr. 1 2019 |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Risk factors for severe acute pain and persistent pain after surgery for breast cancer : a prospective observational study. / Habib, Ashraf S.; Kertai, M.; Cooter, Mary; Greenup, Rachel A.; Hwang, Shelley.
In: Regional Anesthesia and Pain Medicine, Vol. 44, No. 2, 01.02.2019, p. 192-199.Research output: Article
}
TY - JOUR
T1 - Risk factors for severe acute pain and persistent pain after surgery for breast cancer
T2 - a prospective observational study
AU - Habib, Ashraf S.
AU - Kertai, M.
AU - Cooter, Mary
AU - Greenup, Rachel A.
AU - Hwang, Shelley
PY - 2019/2/1
Y1 - 2019/2/1
N2 - BACKGROUND AND OBJECTIVES: There are few prospective studies providing comprehensive assessment of risk factors for acute and persistent pain after breast surgery. This prospective observational study assessed patient-related, perioperative, and genetic risk factors for severe acute pain and persistent pain following breast cancer surgery. METHODS: Women presenting for elective breast cancer surgery completed State Trait Anxiety Inventory, Beck Depression Inventory, and Pain Catastrophizing Scale questionnaires preoperatively. Diffuse noxious inhibitory control and mechanical temporal summation were assessed. A blood sample was obtained for genetic analysis. Analgesic consumption and pain scores were collected in the post-anesthesia care unit, and at 24 and 72 hours. Patients were contacted at 1, 3, 6, and 12 months to assess persistent pain. Primary outcome was maximum acute pain score in first 72 hours and secondary outcome was persistent pain. RESULTS: One hundred twenty-four patients were included in analysis. Increased duration of surgery, surgeon, and higher pain catastrophizing scores were associated with increased severity of acute pain, while preoperative radiotherapy was associated with reduced severity. Persistent pain was reported by 57.3% of patients. Postdischarge chemotherapy (OR 2.52, 95% CI 1.13 to 5.82), postdischarge radiation (OR 3.39, 95% CI 1.24 to 10.41), severe acute pain (OR 5.39, 95% CI 2.03 to 15.54), and moderate acute pain (OR 5.31, 95% CI 1.99 to 15.30) were associated with increased likelihood of persistent pain. CONCLUSIONS: Increased duration of surgery, higher pain catastrophizing score, and surgeon were associated with increased severity of acute pain. Preoperative radiation was associated with lower acute pain scores. Postsurgery radiation, chemotherapy, and severity of acute pain were associated with increased likelihood of persistent pain. TRIAL REGISTRATION: NCT03307525.
AB - BACKGROUND AND OBJECTIVES: There are few prospective studies providing comprehensive assessment of risk factors for acute and persistent pain after breast surgery. This prospective observational study assessed patient-related, perioperative, and genetic risk factors for severe acute pain and persistent pain following breast cancer surgery. METHODS: Women presenting for elective breast cancer surgery completed State Trait Anxiety Inventory, Beck Depression Inventory, and Pain Catastrophizing Scale questionnaires preoperatively. Diffuse noxious inhibitory control and mechanical temporal summation were assessed. A blood sample was obtained for genetic analysis. Analgesic consumption and pain scores were collected in the post-anesthesia care unit, and at 24 and 72 hours. Patients were contacted at 1, 3, 6, and 12 months to assess persistent pain. Primary outcome was maximum acute pain score in first 72 hours and secondary outcome was persistent pain. RESULTS: One hundred twenty-four patients were included in analysis. Increased duration of surgery, surgeon, and higher pain catastrophizing scores were associated with increased severity of acute pain, while preoperative radiotherapy was associated with reduced severity. Persistent pain was reported by 57.3% of patients. Postdischarge chemotherapy (OR 2.52, 95% CI 1.13 to 5.82), postdischarge radiation (OR 3.39, 95% CI 1.24 to 10.41), severe acute pain (OR 5.39, 95% CI 2.03 to 15.54), and moderate acute pain (OR 5.31, 95% CI 1.99 to 15.30) were associated with increased likelihood of persistent pain. CONCLUSIONS: Increased duration of surgery, higher pain catastrophizing score, and surgeon were associated with increased severity of acute pain. Preoperative radiation was associated with lower acute pain scores. Postsurgery radiation, chemotherapy, and severity of acute pain were associated with increased likelihood of persistent pain. TRIAL REGISTRATION: NCT03307525.
KW - acute postoperative pain
KW - breast surgery
KW - persistent pain
KW - quantitative sensory testing
UR - http://www.scopus.com/inward/record.url?scp=85060940921&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060940921&partnerID=8YFLogxK
U2 - 10.1136/rapm-2018-000040
DO - 10.1136/rapm-2018-000040
M3 - Article
C2 - 30700614
AN - SCOPUS:85060940921
VL - 44
SP - 192
EP - 199
JO - Regional Anesthesia and Pain Medicine
JF - Regional Anesthesia and Pain Medicine
SN - 1098-7339
IS - 2
ER -