Table 5.
Oral Medication Studies
| Reference | Procedure | Intervention | Follow-up (mo), Avg. (Range) | Outcome measures | Findings |
|---|---|---|---|---|---|
| Fassoulaki et al., 200144 | Modified radical mastectomy or lumpectomy with ALND | Mexiletine and regional ropivacaine block | 3 | Presence of pain, pain intensity | Oral mexiletine, regional block nor their combination decreased incidence or intensity of chronic pain compared with control. |
| Fassoulaki et al., 200239 | Breast surgery for cancer | Mexiletine vs. gabapentin | 3 | Presence of pain, pain intensity (NRS) | Neither mexiletine nor gabapentin affected pain incidence or intensity compared with control. |
| Hah et al., 199645 | Unilateral/ bilateral mastectomy or breast lumpectomy | Gabapentin | 12 | Presence of pain, pain intensity (BPI) | Gabapentin did not decrease incidence of pain compared with control. |
| Amr et al., 200946 | Partial or radical mastectomy with ALND | Gabapentin and venlafaxine | 6 | Presence of pain, pain intensity (VAS), pain characteristics | Venlafaxine decreased pain intensity (P < 0.0001) and incidences of burning and stabbing pain compared with gabapentin and control. |
| Fassoulaki et al., 200547 | Breast cancer surgery | Multimodal analgesia (oral gabapentin, EMLA cream near incision, irrigation of brachial plexus block) | 6 | Presence of pain, pain intensity | Multimodal analgesia intervention did not decrease incidence of chronic pain. |
| Vig et al., 201942 | Modified radical mastectomy | Pregabalin | 3 | Presence of pain, pain intensity (NRS) | Pregabalin did not decrease incidence nor intensity of chronic pain compared with control. |
| Reyad et al., 201943 | Modified radical mastectomy or conservative breast surgery with ALND | Pregabalin | 6 | Presence of pain, neuropathic pain (GSNP), pain intensity at rest and movement (VAS) | Pregabalin decreased incidence (P < 0.001) and intensity (P = 0.002) of neuropathic pain compared with control. |
| Khan et al., 2019*35 | Unilateral or bilateral mastectomy or lumpectomy | 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 with control, but not severity. Pregabalin had no effect. |
| Lee et al., 201340 | Breast surgery with ALND | Multimodal analgesia (pregabalin and PVB catheter of local anesthetic) | 3 | Presence of pain, pain characteristics (SF-MPQ) | Multimodal analgesic regimen did not decrease pain incidence compared with control. |
| Van Helmond et al., 201641 | Breast cancer surgery | Parecoxib injection and oral celecoxib | 12 | Presence of pain, pain intensity at rest and during movement (VAS), electric pain and pressure pain tolerance thresholds | COX-2 inhibition had no effect on pain intensity compared with control. |
| Na et al., 201848 | Lumpectomy with ALND or SLNB | IV nefopam | 3 | Pain intensity (NRS) | Nefopam decreased |
| incidence of chronic pain (P = 0.04), but had no effect on pain intensity compared with control. |
NRS – Numerical rating scale
BPI – Brief Pain Inventory
VAS – Visual analogue scale
GSNP- Grading system for neuropathic pain
SF-MPQ – Short-form McGill Pain Questionnaire
DN4 – Douleur neuropathique 4