MedPath

The Effects of Anesthetics on Persistent Pain Following Breast Cancer Surgery

Completed
Conditions
Chronic Post-Procedural Pain
Breast Cancer
Interventions
Other: acute postoperative pain
Registration Number
NCT03782896
Lead Sponsor
Samsung Medical Center
Brief Summary

Persistent postoperative pain occurs up to 25 to 60 % after mastectomy. This occurs at a higher frequency than the rate of invasive surgery.Therefore, many ways have been tried to study risk factors. A study was conducted to predict postoperative pain for items (preoperative pain, sensitivity, pain prediction). As a result, it was reported that the scope of surgery, pre-operative pain, young age, and depression were associated with persistent pain.

This study try to find out whether persistent pain after mastectomy is affected anesthetic factors appropriate anesthesia depth and opioid using standardized monitoring devices limited to similar surgical ranges.

Detailed Description

Persistent postoperative pain occurs up to 25 to 60 % after mastectomy. This occurs at a higher frequency than the rate of invasive surgery.Therefore, many ways have been tried to study risk factors. A study was conducted to predict postoperative pain for items (preoperative pain, sensitivity, pain prediction). As a result, it was reported that the scope of surgery, pre-operative pain, young age, and depression were associated with persistent pain.

There were reports of no association with anesthesia in the area of anesthesia to the high pain control requirement in the postoperative recovery room, 24 hours of high pain medication, use of inhalation agent, and a high dosage of remifentanil. However, an anesthesia-related study was either a retrospective study or anesthetic was injected with more than a clinical dose in order to make the difference following methods.

In this study, bispectral index is used to maintain anesthesia depth. In addition, the commercially available noninvasive pain depth equipment (Surgical Pleth Index) is used to assess the nociception-antinociception balance. Displays the automatically calculated values of SPI=100-(0.3\*heartbeat interval + 0.7\*photoplethysmographic pulse wave ampule) using a waveform with peripheral oxygen saturation. Through this process, patients want to objectify the amount of anesthetic agent used during surgery. And all patients are inserted the laryngeal mask airway.

This study would try find out whether persistent pain after mastectomy is affected anesthetic factors appropriate anesthesia depth and opioid using standardized monitoring devices limited to similar surgical ranges.

The investigators hypothesize that patients who suffered severe acute postoperative pain, regardless of their anesthesia method, have a higher incidence of persistent post-mastectomy pain.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
89
Inclusion Criteria

-undergoing breast conserving surgery + sentinel lymph node dissection

Exclusion Criteria
  • cardiac arrythmia
  • allergic history for drugs
  • renal failure (Cr> 1.5 mg/dl)
  • performing axillary lymph node dissection or Total mastectomy
  • difficult airway and failed to place laryngeal mask airway properly

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
mastectomy groupacute postoperative painAll patients who received the mastectomy (breast conserving surgery and sentinel lymph node dissection)
Primary Outcome Measures
NameTimeMethod
persistent painpostoperative 2 months

persistent postoperative pain after mastectomy (Numeric rating pain score (NSR: no pain=1, worst pain=10)

acute postoperative painpostoperative 1 hour

acute postoperative pain in the recovery room measured by Numeric rating pain score (NSR: no pain=1, worst pain=10)

Secondary Outcome Measures
NameTimeMethod
the consumption of postoperative analgesiapostoperative 72 hours

the consumption of postoperative analgesia during in-hospital day

surgical anxiety level1 day before surgery

(0: not anxiety-100: extremely anxious)

surgery factorintraoperative

the incision size and the number of excision of lymph node

The surgical pleth indexintraoperative

the highest surgical pleth index score in time of start anesthesia and ene of anesthesia

anticipated pain medication need1 day before surgery

(0: none at all, 1: much less than average, 2: less than average, 3: average, 4: more than average, 5: much more than average)

The pain score of dischargeon the 1 day of discharge

Numeric rating pain score (NSR: no pain=1, worst pain=10)

opioid consumptionintraoperative

the amount of opioid

anticipate pain1 day before surgery

(0: no pain-100: a bad as you can imagine)

inhalation agentintraoperative

inhalation anesthetics use or total intravenous anesthesia

Trial Locations

Locations (1)

Samsung Medical Center

🇰🇷

Seoul, Gangnam-gu, Korea, Republic of

© Copyright 2025. All Rights Reserved by MedPath