Elsevier

The Breast

Volume 11, Issue 2, April 2002, Pages 156-162
The Breast

Regular Article
Immediate reconstruction in breast cancer surgery requires intensive post-operative pain treatment but the effects of axillary dissection may be more predictive of chronic pain

https://doi.org/10.1054/brst.2001.0386Get rights and content

Abstract

The aim of this study was to investigate post-operative pain intensity, analgesic consumption and the incidence of chronic pain in women after different types of breast cancer surgery. Patients were randomized to either patient-controlled analgesia or nurse-administered analgesia. Opioid-consumption was registered for 24 h. A division of the patient-material into four subgroups was performed: (1) mastectomy; (2) mastectomy and axillary lymph node dissection; (3) mastectomy and reconstruction; and (4) mastectomy, reconstruction and axillary lymph node dissection. Visual analogue scale was used to measure pain intensity. Four years after surgery, a questionnaire regarding persistent pain was completed. Patients undergoing reconstruction scored higher pain levels than the others. Patient-controlled analgesia provided better pain relief but also considerably higher consumption of opioids by the women who underwent breast reconstruction. The incidence of remaining pain was 25% after 3–4 years. Immediate breast reconstruction causes severe post-operative pain that can respond poorly to opioids. Chronic pain after breast cancer surgery is common and should be further analysed aiming at better prevention and treatment options.

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Address correspondence to: Christina Olofsson MD, PhD, Associate Professor, Department of Anaesthesia and Intensive Care, Karolinska Hospital, S 171 76 Stockholm, Sweden. Tel.: +46 8 517 720 66; Fax: +46 8 30 77 95; E-mail: [email protected]

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