Table 4.
Anesthesia Studies
| Reference | Procedure | Intervention | Follow-up (mo), Avg (Range) | Outcome measures | Findings |
|---|---|---|---|---|---|
| Cho et al., 201229 | Breast cancer surgery | Propofol vs. sevoflurane anesthesia | 39 (30, 48) | Presence of pain, pain intensity (NRS), pain interference with daily life | Sevoflurane resulted in higher incidence of chronic pain compared to propofol (P = 0.007), but not pain intensity. |
| Lefebvre-Kuntz et al., 201532 | Breast cancer surgery | Propofol vs. halogenated anesthetic | 6 | Presence of pain, Neuropathic pain (DN4, Neuropathic Pain Symptom Inventory), pain intensity (VAS), | Type of general anesthetic had no effect on incidence nor intensity of pain. |
| Grigoras et al., 2013 | Mastectomy or wide local excision with ALND | IV lidocaine infusion | 3 | Presence of pain, intensity of pain (SF-MPQ, VAS) character of pain, interference with daily life | Lidocaine resulted in lower pain incidence (P = 0.031) and intensity (0.025) compared to control. |
| Terkawi et al., 201738 | Mastectomy | IV lidocaine infusion | 6 | Presence of pain, pain intensity (NRS), pain characteristics | Lidocaine was associated with a 20-fold decrease in incidence of CPSP compared to control (P = 0.013). |
| Kim et al., 201737 | Breast cancer surgery | Systemic lidocaine infusion vs. magnesium | 3 | Presence of pain, pain intensity and quality (Korean SF-MPQ) | Lidocaine significantly decreased pain intensity compared to control (P = 0.046), but had no effect on chronic pain incidence. Magnesium had no effect. |
| Kendall et al., 201834 | Breast cancer surgery | IV lidocaine infusion | 6 | Presence of pain, pain intensity (NRS, BPI, SF-MPQ), neuropathic pain (S-LANSS) | Lidocaine reduced pain incidence (P = 0.04) compared to control and had no effect on intensity. |
| Khan et al., 2019*35 | Unilateral or bilateral mastectomy or lumpectomy | Perioperative pregabalin and lidocaine infusion | 3 | Presence of pain, pain intensity (BPI, SF-MPQ2), neuropathic pain (DN4) | Lidocaine decreased incidence of persistent neuropathic pain (P = 0.049) compared to control, but not intensity. Pregabalin had no effect. |
| Sun et al., 201231 | Mastectomy with ALND | Perioperative IV flurbiprofen axetil | 12 | Presence of pain, pain intensity (NRS), nature of pain | Flurbiprofen axetil resulted in lower pain incidence for 6 months postoperatively, but not 12 months. It significantly lowered pain intensity (P < 0.05). |
| Kang et al., 202033 | Unilateral breast cancer surgery | IV ketamine | 6 | Presence of pain, pain intensity at rest and movement (NRS), Neuropathic pain (DN4) | Ketamine did not reduce pain intensity compared with control. Pain incidence was lower at 3 months, but not 6. |
| Jain et al., 201236 | Breast cancer surgery | IV dexmedetomidine | 3 | Presence of pain, pain intensity (BPI, SF-MPQ2) | Dexmedetomidine decreased pain intensity (P < 0.001) and incidence (P < 0.001) compared with control. |
NRS – Numerical rating scale
DN4 – Douleur neuropathique 4
VAS – Visual analogue scale
SF-MPQ – Short-form McGill Pain Questionnaire
BPI – Brief Pain Inventory
S-LANSS – Self-administered Leeds Assessment of Neuropathic Symptoms and Signs
QOL – Quality of life
IV – Intravenous