Review Article

Can Acute Pain Treatment Reduce Postsurgical Comorbidity after Breast Cancer Surgery? A Literature Review

Table 1

Analgesic effect on the quality of recovery after the surgery.

Surgical procedureAnalgesic modalityOutcomesStudy designSample sizeJournals (year)1st authorCitation

Nerve block
Mastectomy plus immediate reconstructionPVB with Bupivacaine 0.5% versus nonblockReduced length of stay and PONV in PVB groupRetrospective studyAnn. Surg. Oncol. (2013)Coopey [12]
Mastectomy with or without immediate reconstructionPVB versus nonblockPVB reduced PONV incidenceRetrospective studyAnn. Surg. Oncol. (2014)Fahy [13]
Pt mastectomy with SLNB, mastectomy with or without SLNB or ALND, and mastectomy with reconstructionPVB with ropivacaine 0.5% versus sham blockHigher QoR score, reduced discharge time, and reduced PONV in PVB groupProspective studyAnesthesiology (2014)Abdallah[14]
Mastectomy with ALNDPECS versus nonblockPECS reduced PONV incidenceProspective studyReg. Anesth. Pain Med. (2015)Bashandy[15]

LA injection at surgical site
Pt mastectomy with or without ALNDRopivacaine 0.375% versus saline before surgeryIncidence of PONV did not change between two groupsProspective studyActa Anaesthesiol. Scand. (2000)Johansson[16]
Mastectomy with ALNDBupivacaine 0.25% versus noninjectionReduced hospital stay, pain intensity in bupivacaine groupRetrospective studyActa Chir. Belg. (2011)Lu [17]

Systemic analgesic drug
Mastectomy with or without ALND, Pt mastectomy with or without ALNDClonidine or placebo Clonidine reduced PONV incidenceProspective studyAnesthesiology (2002)Oddby-Muhrbeck [20]
Mastectomy with ALNDDexmedetomidine or salineHigher QoR score in dexmedetomidine groupProspective studyMinerva Anestesiol. (2013)Kim[21]
Mastectomy with ALNDGabapentin or placebo before surgeryGabapentin reduced pain intensity but not PONV incidenceProspective studyAnesthesiology (2002)Dirks[18]
Mastectomy with or without ALND, Pt mastectomy with or without ALNDPregabalin or placebo before surgeryPregabalin reduced pain intensity but not PONV incidenceProspective studyActa Anaesthesiol. Scand. (2011)Kim[19]
Pt mastectomy with or without ALNDMagnesium or salineHigher QoR score in magnesium groupProspective studyMagnes. Res. (2013) de Oliveira[22]
Mastectomy with ALNDDexamethasone or placeboIncidence of PONV and intensity of pain reduced in dexamethasone groupProspective studyBMC Cancer (2010)Gómez-Hernández[26]
Pt mastectomy with or without ALNDBetamethasone or no-treatment controlIncidence of PONV and intensity of pain reduced in betamethasone groupProspective studyJ. Clin. Anesth. (2014)Olanders[25]

Pt mastectomy: partial mastectomy, SLNB: sentinel lymph node biopsy, and ALND: axillary lymph node dissection.