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Chronic adverse effects after an axillary lymphadenectomy in breast cancer patients after administering weaker and stronger postoperative analgesia: results of a prospective double-blind randomized study.
Breast Cancer Res Treat. 2020 Aug; 182(3):655-663.BC

Abstract

PURPOSE

The aim of this study was to compare the rate of chronic adverse effects after a weaker and stronger postoperative analgesia.

METHODS

A prospective double-blind randomized study included 117 breast cancer patients receiving tramadol for pain relief for 4 weeks after an axillary lymphadenectomy from 2015 to 2018. Patients with a larger dose received 75/650 mg of tramadol with paracetamol every 8 h and a group with a lower dose received 37.5/325 mg of tramadol with paracetamol every 8 h from the 2nd to the 29th postoperative day. 1 year after surgery, patients were evaluated for the presence of neuropathic pain, chronic pain, arm symptoms and lymphedema.

RESULTS

There was a trend for a lower rate of neuropathic pain after stronger analgesia in comparison to weaker analgesia (p = 0.059). Chronic pain was present in 18% of patients 1 year after the lymphadenectomy. There was no difference in the rate of chronic pain after stronger and weaker postoperative analgesia. Patients had less arm symptoms after a stronger analgesia than after a weaker analgesia (p = 0.02). Furthermore, there was a trend for a lower rate of lymphedema of the forearm after a stronger analgesia than after a lower analgesia (p = 0.078).

CONCLUSIONS

The patients who received a stronger postoperative analgesia had less arm symptoms and a better quality of life in comparison to patients who received a weaker analgesia. The patients who received a stronger postoperative analgesia had a statistical trend for less neuropathic pain in comparison to patients who received a weaker analgesia.

Authors+Show Affiliations

Department of Surgical Oncology, Institute of Oncology, Zaloska 2, 1000, Ljubljana, Slovenia. nbesic@onko-i.si.Faculty of Mathematics and Physics, University of Ljubljana, 1000, Ljubljana, Slovenia.Department of Anesthesiology, Institute of Oncology, Zaloska 2, 1000, Ljubljana, Slovenia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32557338

Citation

Besic, Nikola, et al. "Chronic Adverse Effects After an Axillary Lymphadenectomy in Breast Cancer Patients After Administering Weaker and Stronger Postoperative Analgesia: Results of a Prospective Double-blind Randomized Study." Breast Cancer Research and Treatment, vol. 182, no. 3, 2020, pp. 655-663.
Besic N, Smrekar J, Strazisar B. Chronic adverse effects after an axillary lymphadenectomy in breast cancer patients after administering weaker and stronger postoperative analgesia: results of a prospective double-blind randomized study. Breast Cancer Res Treat. 2020;182(3):655-663.
Besic, N., Smrekar, J., & Strazisar, B. (2020). Chronic adverse effects after an axillary lymphadenectomy in breast cancer patients after administering weaker and stronger postoperative analgesia: results of a prospective double-blind randomized study. Breast Cancer Research and Treatment, 182(3), 655-663. https://doi.org/10.1007/s10549-020-05713-3
Besic N, Smrekar J, Strazisar B. Chronic Adverse Effects After an Axillary Lymphadenectomy in Breast Cancer Patients After Administering Weaker and Stronger Postoperative Analgesia: Results of a Prospective Double-blind Randomized Study. Breast Cancer Res Treat. 2020;182(3):655-663. PubMed PMID: 32557338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic adverse effects after an axillary lymphadenectomy in breast cancer patients after administering weaker and stronger postoperative analgesia: results of a prospective double-blind randomized study. AU - Besic,Nikola, AU - Smrekar,Jaka, AU - Strazisar,Branka, Y1 - 2020/06/18/ PY - 2020/02/14/received PY - 2020/05/26/accepted PY - 2020/6/20/pubmed PY - 2020/6/20/medline PY - 2020/6/20/entrez KW - Analgesia KW - Breast cancer KW - Pain KW - Surgery SP - 655 EP - 663 JF - Breast cancer research and treatment JO - Breast Cancer Res. Treat. VL - 182 IS - 3 N2 - PURPOSE: The aim of this study was to compare the rate of chronic adverse effects after a weaker and stronger postoperative analgesia. METHODS: A prospective double-blind randomized study included 117 breast cancer patients receiving tramadol for pain relief for 4 weeks after an axillary lymphadenectomy from 2015 to 2018. Patients with a larger dose received 75/650 mg of tramadol with paracetamol every 8 h and a group with a lower dose received 37.5/325 mg of tramadol with paracetamol every 8 h from the 2nd to the 29th postoperative day. 1 year after surgery, patients were evaluated for the presence of neuropathic pain, chronic pain, arm symptoms and lymphedema. RESULTS: There was a trend for a lower rate of neuropathic pain after stronger analgesia in comparison to weaker analgesia (p = 0.059). Chronic pain was present in 18% of patients 1 year after the lymphadenectomy. There was no difference in the rate of chronic pain after stronger and weaker postoperative analgesia. Patients had less arm symptoms after a stronger analgesia than after a weaker analgesia (p = 0.02). Furthermore, there was a trend for a lower rate of lymphedema of the forearm after a stronger analgesia than after a lower analgesia (p = 0.078). CONCLUSIONS: The patients who received a stronger postoperative analgesia had less arm symptoms and a better quality of life in comparison to patients who received a weaker analgesia. The patients who received a stronger postoperative analgesia had a statistical trend for less neuropathic pain in comparison to patients who received a weaker analgesia. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/32557338/Chronic_adverse_effects_after_an_axillary_lymphadenectomy_in_breast_cancer_patients_after_administering_weaker_and_stronger_postoperative_analgesia:_results_of_a_prospective_double-blind_randomized_study L2 - https://doi.org/10.1007/s10549-020-05713-3 DB - PRIME DP - Unbound Medicine ER -
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