S. Sahni, Ronak Patel, Li Wang, S. Miles, Elad Dana, J. Khan
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Pain was primarily located in the axilla, chest, and shoulder, with the vast majority of patients with pain (96.2%) reporting a neuropathic pain feature. The mean intensity of pain was 2.5 (standard deviation [SD] 2.4, on a 0 to 10 pain scale) and persistent pain was associated with worse quality of life scores (p = 0.004) and increased use of analgesics (p = 0.015). Variables found to be associated with persistent pain in our univariable and multivariable-adjusted analyses were preoperative employment (OR 2.70, 95% CI 1.04–9.66, p = 0.042), acute postoperative pain during movement (OR 1.63, 95% CI 1.06–2.51, p = 0.027), and adjuvant chemotherapy (OR 3.30, 95% CI 1.19 to 9.15, p = 0.022). Conclusions: Persistent pain after breast cancer surgery is neuropathic and is associated with reduced quality of life and increased analgesic need. Future research should focus on perioperative interventions to reduce acute postoperative pain and consideration of modified adjuvant chemotherapy regimens to address modifiable risk factors and potentially reduce the incidence of persistent pain after breast cancer surgery.","PeriodicalId":93623,"journal":{"name":"Surgeries","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study\",\"authors\":\"S. Sahni, Ronak Patel, Li Wang, S. Miles, Elad Dana, J. Khan\",\"doi\":\"10.3390/surgeries4030031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: Persistent pain is a common complication after breast cancer surgery. We sought to determine the characteristics of persistent pain after breast cancer surgery and identify perioperative risk factors associated with its development. Methods: This prospective cohort study uses data from a prior randomized controlled trial of 100 patients undergoing breast cancer surgery. Patients were assessed on the presence and characteristics of pain at 3 months after surgery. Baseline and perioperative data were explored for potential associations with persistent pain in univariate and multivariate logistic regression models. Results: Fifty-three percent of patients reported persistent pain 3-months after surgery. Pain was primarily located in the axilla, chest, and shoulder, with the vast majority of patients with pain (96.2%) reporting a neuropathic pain feature. The mean intensity of pain was 2.5 (standard deviation [SD] 2.4, on a 0 to 10 pain scale) and persistent pain was associated with worse quality of life scores (p = 0.004) and increased use of analgesics (p = 0.015). Variables found to be associated with persistent pain in our univariable and multivariable-adjusted analyses were preoperative employment (OR 2.70, 95% CI 1.04–9.66, p = 0.042), acute postoperative pain during movement (OR 1.63, 95% CI 1.06–2.51, p = 0.027), and adjuvant chemotherapy (OR 3.30, 95% CI 1.19 to 9.15, p = 0.022). Conclusions: Persistent pain after breast cancer surgery is neuropathic and is associated with reduced quality of life and increased analgesic need. Future research should focus on perioperative interventions to reduce acute postoperative pain and consideration of modified adjuvant chemotherapy regimens to address modifiable risk factors and potentially reduce the incidence of persistent pain after breast cancer surgery.\",\"PeriodicalId\":93623,\"journal\":{\"name\":\"Surgeries\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgeries\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3390/surgeries4030031\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgeries","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/surgeries4030031","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:持续疼痛是乳腺癌术后常见的并发症。我们试图确定乳腺癌手术后持续疼痛的特征,并确定与其发展相关的围手术期危险因素。方法:这项前瞻性队列研究使用了100例接受乳腺癌手术患者的随机对照试验数据。术后3个月评估患者疼痛的存在和特征。在单变量和多变量logistic回归模型中探讨基线和围手术期数据与持续性疼痛的潜在关联。结果:53%的患者报告术后3个月持续疼痛。疼痛主要位于腋窝、胸部和肩部,绝大多数疼痛患者(96.2%)报告神经性疼痛特征。平均疼痛强度为2.5(标准偏差[SD] 2.4,在0到10的疼痛量表上),持续疼痛与生活质量评分较差(p = 0.004)和止痛药使用增加(p = 0.015)相关。在我们的单变量和多变量调整分析中发现与持续疼痛相关的变量是术前工作(OR 2.70, 95% CI 1.04-9.66, p = 0.042),术后运动时急性疼痛(OR 1.63, 95% CI 1.06-2.51, p = 0.027)和辅助化疗(OR 3.30, 95% CI 1.19 - 9.15, p = 0.022)。结论:乳腺癌手术后持续疼痛是神经性的,与生活质量下降和镇痛需求增加有关。未来的研究应侧重于围手术期干预,以减少术后急性疼痛,并考虑改良的辅助化疗方案,以解决可改变的危险因素,并可能减少乳腺癌手术后持续疼痛的发生率。
Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study
Objective: Persistent pain is a common complication after breast cancer surgery. We sought to determine the characteristics of persistent pain after breast cancer surgery and identify perioperative risk factors associated with its development. Methods: This prospective cohort study uses data from a prior randomized controlled trial of 100 patients undergoing breast cancer surgery. Patients were assessed on the presence and characteristics of pain at 3 months after surgery. Baseline and perioperative data were explored for potential associations with persistent pain in univariate and multivariate logistic regression models. Results: Fifty-three percent of patients reported persistent pain 3-months after surgery. Pain was primarily located in the axilla, chest, and shoulder, with the vast majority of patients with pain (96.2%) reporting a neuropathic pain feature. The mean intensity of pain was 2.5 (standard deviation [SD] 2.4, on a 0 to 10 pain scale) and persistent pain was associated with worse quality of life scores (p = 0.004) and increased use of analgesics (p = 0.015). Variables found to be associated with persistent pain in our univariable and multivariable-adjusted analyses were preoperative employment (OR 2.70, 95% CI 1.04–9.66, p = 0.042), acute postoperative pain during movement (OR 1.63, 95% CI 1.06–2.51, p = 0.027), and adjuvant chemotherapy (OR 3.30, 95% CI 1.19 to 9.15, p = 0.022). Conclusions: Persistent pain after breast cancer surgery is neuropathic and is associated with reduced quality of life and increased analgesic need. Future research should focus on perioperative interventions to reduce acute postoperative pain and consideration of modified adjuvant chemotherapy regimens to address modifiable risk factors and potentially reduce the incidence of persistent pain after breast cancer surgery.