Indian Journal of Pain (Jan 2019)
Risk factors analysis for development of chronic postsurgical pain after modified radical mastectomy: A single-centered, prospective, observational study
Abstract
Background: The “chronic post-surgical pain” (CPSP) is defined as pain of at least 2 months duration which has developed after a surgical procedure when other causes such as disease recurrence or preexisting pain syndromes are ruled out. The incidence of CPSP is found maximum after amputation surgeries (50%–85%), followed by thoracotomy (30%–50%) and mastectomy. The aim of our study is to analyze the risk factors such as preoperative pain, anxiety, and specific surgical techniques for development of CPSP after modified radical mastectomy (MRM). Materials and Methods: A total of thirty patients undergoing MRM satisfying inclusion criteria were enrolled out, of which one patient died during the study period of 1 year. Preoperative pain evaluation was done with Visual Analog Scale, and for measuring preoperative anxiety, Hamilton Anxiety Rating Scale was used. Medical and surgical records were studied for evaluation of some postoperative parameters. Appropriate statistical tests were used to evaluate the relationship of different risk factors for development of CPSP. Results: Incidence proportion of CPSP in our study was approximately 24%. All the risk factors we analyzed, i.e. preoperative pain and anxiety, surgical techniques like preservation of intercostobrachialis nerve, type of surgical incision, and duration of surgery were found to be statistically insignificant for development of CPSP. Conclusion: In conclusion, one should be very cautious to identify women who are at risk of developing CPSP or who have already developed CPSP. Establishing a prediction model based on known risk factors to identify susceptible patients and applying protective measures are important steps toward preventive, personalized health care.
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