Anesthetic Used During Mastectomy Effects Chronic Pain

Anesthetic Used During Mastectomy Effects Chronic Pain

bigstock-Surgeons-See-more-in-my-portf-12370376The type of anesthetic a woman receives during a mastectomy may increase her chances of suffering long term chronic pain according to a new study published in the journal Anesthesia & Analgesia.

Researchers at the Pusan National University in Busan, Korea found that breast cancer patients given the anesthesia propofol (Diprivan) were 50 percent less likely to experience chronic pain than patients who were given sevoflurane.

“This study suggests that anesthetics during breast cancer surgery may affect the development of chronic pain,” the authors wrote.

A team led by Dr. Ah-Reum Cho compared the results of 175 women given either propofol or sevoflurane, both of which are commonly used during surgery to render the patient unconscious.

In a follow up survey four years after surgery, more than half of the women (56%) reported having chronic pain. The women were also asked if the pain interfered with mobility, self-care and daily activities or work.

The women given propofol reported less long-term pain (44%) than those given sevoflurane (67%). Even when other factors were considered, the women given sevoflurane were 50 percent more likely to have pain years after surgery than those given propofol.

For women who reported pain, the type of anesthesia did not impact severity or how long the pain lasted.

Researchers also found that those at greatest risk for chronic pain tended to be younger women who often had more extensive cancer requiring complex surgery that included the removal of lymph nodes in the armpit.

Women who needed more morphine for pain relief immediately after the surgery were also more prone to experience long-lasting pain. Morphine use after surgery turned out to be a major risk factor for long-lasting pain.

Chronic pain after surgery is often reported by patients and anesthesiologists say identifying risk factors to minimize chronic pain can have a major impact on improving a patient’s quality of life.

“This study showed that propofol anesthesia was associated with a lower incidence of chronic pain after breast cancer surgery than sevoflurane anesthesia,” said Cho, who emphasized that chronic pain is also influenced by other factors and the study did prove any cause-and-effect relationship.

“Further prospective studies are needed to confirm the validity of these provocative findings,” he wrote.

The Centers for Disease Control and Prevention reports that breast cancer is the second most common cancer among women in the United States. It is also one of the leading causes of cancer death among women of all races and Hispanic origin populations.

In 2009, the most recent year where numbers are available, more than 211,000 women in the United States were diagnosed with breast cancer. In that same year, over 40,000 women died from breast cancer.

According to breastcancer.org, in 2011, an estimated 230,480 new cases of invasive breast cancer were expected to be diagnosed in the U.S.

Authored by: Richard Lenti