Acute and Persistent Postoperative Pain after Breast Surgery

被引:161
作者
Fecho, Karamarie [1 ]
Miller, Natalie R. [1 ]
Merritt, Sarah A. [1 ]
Klauber-DeMore, Nancy [2 ]
Hultman, C. Scott [3 ]
Blau, William S. [1 ]
机构
[1] Univ N Carolina, Dept Anesthesiol, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Div Surg Oncol, Dept Surg, Chapel Hill, NC 27599 USA
[3] Univ N Carolina, Div Plast & Reconstruct Surg, Dept Surg, Chapel Hill, NC 27599 USA
关键词
Acute Pain; Persistent Pain; Postoperative Pain; Mastectomy; Breast Reconstruction; BLOOD-PRESSURE; CANCER SURGERY; RISK-FACTORS; SEVERITY; RECONSTRUCTION; SENSITIVITY; SYMPTOMS;
D O I
10.1111/j.1526-4637.2009.00611.x
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
This study's primary aim was to determine levels of acute and persistent postoperative pain and the incidence of severe postoperative pain after mastectomy. A secondary aim was to examine factors associated with postoperative pain. A retrospective cohort study of 196 female breast surgery subjects was conducted. Data were collected on: numerical rating scale (NRS) pain scores in the Post Anesthesia Care Unit (PACU) and at 1 month and 6-12 months postoperative; age; race; insurance; obesity; radiotherapy; chemotherapy; hypertension; anesthesia care time; and intraoperative and PACU opioid use. Severe postoperative pain was defined as NAS >= 5. Data were analyzed using chi square, Fisher's exact test or analysis of variance, with alpha = 0.05. PACU pain and the incidence of severe PACU pain increased with surgical complexity (P < 0.005). PACU pain scores averaged 4.71 +/- 0.24 and 57.7% of subjects experienced severe pain. Postoperative pain scores at 1 or 6-12 months did not vary by surgical complexity and averaged 2.21 +/- 0.32 and 0.74 +/- 0.22, respectively. Severe postoperative pain was experienced by 22.1% of subjects at 1 month and 8.2% of subjects at 6-12 months. Older age and systolic hypertension were associated with less PACU pain. Non-White race, obesity, and high PACU opioid use were associated with greater postoperative pain at 1 month. Non-White people also had greater postoperative pain at 6-12 months. The results suggest that nearly 60% of breast surgery patients experience severe acute postoperative pain, with severe pain persisting for 6-12 months in almost 10% of patients.
引用
收藏
页码:708 / 715
页数:8
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