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

Table 2

Analgesic effect on the persistent postsurgical pain.

Surgical procedure	Analgesic modality	Outcomes	Study design	Sample size	Journals (year)	1st author	Citation
Nerve block
Pt mastectomy with or without ALND, mastectomy with or without ALND	PVB with 0.5% bupivacaine versus saline before surgery	Intensity and prevalence of pain reduced 12 mo after the surgery	Prospective study		Anesth. Analg. (2006)	Kairaluoma	[33]
Pt mastectomy with ALND, mastectomy with or without ALND or SLNB	PVB with 0.5% ropivacaine before surgery versus wound injection with 0.5% ropivacaine at the end of surgery	Prevalence of pain 12 mo after the surgery was similarly low in both groups	Prospective study		Ann. Surg. Oncol. (2014)	Chiu	[34]
Mastectomy with or without ALND	PVB with 0.4% ropivacaine versus saline daily for 3 days after the surgery	Prevalence of pain 12 mo after the surgery was lower in PVB group	Prospective study		Ann. Surg. Oncol. (2014)	Ilfeld	[35]
LA injection at surgical site
Mastectomy with ALND,; Pt mastectomy with ALND	EMLA versus placebo for 4 days after the surgery	Pain at the surgical site reduced 3 mo after the surgery	Prospective study		Reg. Anesth. Pain Med. (2000)	Fassoulaki	[30]
Mastectomy with ALND,; Pt mastectomy with ALND	Ropivacaine 0.75% versus saline at the end of surgery	Similar pain condition 2 mo after the surgery	Prospective study		BMC Anesthesiol. (2011)	Vigneau	[28]
Pt mastectomy with ALND,; mastectomy with or without ALND or SLNB	Ropivacaine 0.375% versus saline at the end of surgery	Similar pain condition 3–12 mo after the surgery	Prospective study		Anesthesiology (2013)	Albi-Feldzer	[29]
Mastectomy with reconstruction	Levobupivacaine 0.25% for 2 days after the surgery	Levobupivacaine reduced pain intensity 3 mo after the surgery	Prospective study		World J. Surg. Oncol. (2014)	Strazisar	[31]
Systemic analgesic drug
Mastectomy with ALND,; Pt mastectomy with ALND	Mexiletine versus gabapentin versus placebo for 10 days	Intensity and incidence of pain 3 months after the surgery were similar. Sensation of burning pain reduced in mexiletine and gabapentin group	Prospective study		Anesth. Analg. (2002)	Fassoulaki	[38]
Mastectomy with ALND,; Pt mastectomy with ALND	Venlafaxine versus gabapentin versus placebo for 10 days after the surgery	Venlafaxine reduced the incidence of pain 6 mo after the surgery	Prospective study		Clin. J. Pain (2010)	Amr	[37]
Pt Mastectomy with ALND or SLNB, mastectomy with ALND or SLNB	IV lidocaine versus saline during the surgery	Prevalence of pain 3 mo after the surgery reduced in lidocaine group	Prospective study		Clin. J. Pain (2012)	Grigoras	[36]

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