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Mastectomy pain

Jessica Quinlan-Woodward, Autumn Gode, Jeffery A Dusek, Adam S Reinstein, Jill R Johnson, Sue Sendelbach
PURPOSE/OBJECTIVES: To compare the effect of acupuncture to a standard-of-care (control) group on pain, nausea, anxiety, and ability to cope. 
. DESIGN: Pilot randomized, controlled trial. 
. SETTING: Abbott Northwestern Hospital, a large, urban, tertiary care hospital in Minneapolis, Minnesota.
. SAMPLE: 30 adult women undergoing surgery for breast cancer.
. METHODS: Women were randomly assigned to two hospital-based acupuncture treatments versus usual care after breast cancer surgery...
November 1, 2016: Oncology Nursing Forum
Sahar Abdel-Baky Mohamed, Hala Saad Abdel-Ghaffar, Shereen Mamdouh Kamal, Khaled Mohamed Fares, Hesham Mahmoud Hamza
BACKGROUND AND OBJECTIVES: Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. METHODS: In this registered clinical trial ( identifier: NCT02462577), 90 patients were allocated to receive 10 mL plain bupivacaine 0.5% plus either 5, 10, or 15 mg morphine (designated by the group names Morphine5, Morphine10, and Morphine15, respectively)...
October 11, 2016: Regional Anesthesia and Pain Medicine
Vera Ramos, João Fraga, Teresa Simões, Margarida Figueiredo Dias
We report a case of a 36-year-old woman that presented with a painful mass in the outer quadrants of the left breast that had grown rapidly. Physical examination revealed a well circumscribed elastic mass and breast ultrasound showed a cyst measuring 26 mm with vegetation growing on the inner wall. Microscopic evaluation, after fine needle aspiration cytology (FNAC), suggested benign lesion. Tumorectomy was performed and the final diagnosis was a pure squamous cell carcinoma (SCC) of the breast. A simple mastectomy with sentinel node biopsy was performed...
2016: Case Reports in Obstetrics and Gynecology
Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
Canan Kelten, Ceren Boyaci, Cem Leblebici, Kemal Behzatoglu, Didem C Trabulus, Serkan Sari, Mehmet A Nazli, Erol R Bozkurt
BACKGROUND: Malignant phyllodes tumors of the breast are rare biphasic neoplasms. Only few cases related to pregnancy have been reported. CASE REPORT: A 37-year-old woman presented with swelling and pain in her left breast as well as hyperemia on the breast skin, 4 weeks after labor. In her family history, her aunt and maternal cousin had had a breast cancer diagnosis. Clinical evaluation of the patient was consistent with a breast abscess. Therefore, abscess drainage and biopsy from the cavity wall were performed...
August 2016: Breast Care
Marcus Hards, Arisa Harada, Isobel Neville, Sheelagh Harwell, Mahwash Babar, Abdulsatar Ravalia, Giles Davies
STUDY OBJECTIVES: To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. DESIGN: We performed a retrospective study of elective breast surgery patients undergoing mastectomy over 6 months. We collected data on the outcomes for the pain score and use of analgesia in recovery, the use of analgesia and antiemetics overnight, and the pain score and mobilization status of the patient 1 day after the operation...
November 2016: Journal of Clinical Anesthesia
Diab Fuad Hetta, Montaser A Mohamed, Mohammad Farouk Mohammad
STUDY OBJECTIVE: We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption. DESIGN: Prospective randomized controlled clinical trial. SETTING: Postanesthesia care unit. PATIENTS: One hundred twenty adult women scheduled for unilateral (MRM) with axillary evacuation. INTERVENTIONS: Patients were randomized to receive either, placebo capsule, pregabalin 75 mg, pregabalin 150 mg, or pregabalin 300 mg...
November 2016: Journal of Clinical Anesthesia
Diab Fuad Hetta, Khalid Mohammed Rezk
STUDY OBJECTIVE: The aim of this study was to evaluate the analgesic efficacy and safety of pectoralis-serratus interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain. DESIGN: A prospective randomized controlled study. SETTING: Tertiary center, university hospital. PATIENTS: Sixty-four adult women, American Society of Anesthesiologists physical status classes I, II, and III, scheduled for unilateral modified radical mastectomy with axillary evacuation...
November 2016: Journal of Clinical Anesthesia
Aziz Ari, Cihad Tatar, Kenan Buyukasik, Ozgur Segmen, Coskun Cakir, Soykan Arikan
INTRODUCTION: Cancer developing from more than one origin is called multiple primary cancer (MPC) and is a rare situation. In this article, we report a case presenting to the Emergency Clinic with symptoms of ileus who was diagnosed with synchronous colon and breast cancer. PRESENTATION OF CASE: A 57year old male patient presented to the Emergency Clinic with abdominal pain, vomiting, constipation and lack of flatulence. The patient was taken to the operating room for emergency surgery with the diagnosis of intestinal obstruction...
September 22, 2016: International Journal of Surgery Case Reports
Ahmed H Othman, Ahmad M Abd El-Rahman, Fatma El Sherif
BACKGROUND: Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES: This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupivacaine in patients undergoing breast cancer surgery. STUDY DESIGN: A randomized, double-blind, prospective study...
September 2016: Pain Physician
Krishna S Vyas, Sibi Rajendran, Shane D Morrison, Afaaf Shakir, Samir Mardini, Valerie Lemaine, Maurice Y Nahabedian, Stephen B Baker, Brian D Rinker, Henry C Vasconez
BACKGROUND: Management of postoperative pain often requires multimodal approaches. Suboptimal dosages of current therapies can leave patients experiencing periods of insufficient analgesia, often requiring rescue therapy. With absence of a validated and standardized approach to pain management, further refinement of treatment protocols and targeted therapeutics is needed. Liposomal bupivacaine (Exparel) is a longer acting form of traditional bupivacaine that delivers the drug by means of a multivesicular liposomal system...
October 2016: Plastic and Reconstructive Surgery
Sudha Arumugam, Christine Sm Lau, Ronald S Chamberlain
OBJECTIVES: Effective postoperative pain management is crucial in the care of surgical patients. Opioids, which are commonly used in managing postoperative pain, have a potential for tolerance and addiction, along with sedating side effects. Gabapentin's use as a multimodal analgesic regimen to treat neuropathic pain has been documented as having favorable side effects. This meta-analysis examined the use of preoperative gabapentin and its impact on postoperative opioid consumption. MATERIALS AND METHODS: A comprehensive literature search was conducted to identify randomized control trials that evaluated preoperative gabapentin on postoperative opioid consumption...
2016: Journal of Pain Research
Daniel Waltho, Gloria Rockwell
BACKGROUND: Post-mastectomy pain syndrome (PMPS) is a frequent complication of breast surgery. There is currently no standard definition for this chronic pain syndrome. The purpose of this review was to establish a consensus for defining PMPS by identifying the various elements included in the definitions and how they vary across the literature, determining how these definitions affect the methodological components therein, and proposing a definition that appropriately encompasses all of the appropriate elements...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Murial Brackstone
Chronic pain presents a management challenge for physicians and patients alike, and post-mastectomy pain is no exception. In this issue, Waltho and Rockwell present a review of post-mastectomy pain syndrome (PMPS) and propose a standard definition that should allow future studies to be comparable. The proposed definition of "post-breast surgery pain syndrome" includes pain after any type of breast surgery that is of at least moderate intensity and comprises neuropathic qualities, that is present in the ipsilateral breast/chest/arm, that lasts longer than 6 months and is present at least half the time...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Nicholas D Ward, Jennifer W Harris, David A Sloan
Necrotizing fasciitis is a rare, aggressive, soft-tissue infection that results in necrosis of skin, subcutaneous tissue, and fascia. It spreads rapidly and may progress to sepsis, multi-organ failure, and death. Predisposing conditions include diabetes, chronic alcoholism, advanced age, vascular disease, and immunosuppression and many cases are preceded by an injury or invasive procedure. Necrotizing soft-tissue infection of the breast is uncommon, with only a few reported cases in the literature. We present a 53-year-old diabetic woman who presented to the emergency room with several weeks of worsening breast and shoulder pain, swelling, and erythema...
September 16, 2016: Breast Journal
Maureen V Hill, Michelle L McMahon, Ryland S Stucke, Richard J Barth
OBJECTIVE: To examine opioid prescribing patterns after general surgery procedures and to estimate an ideal number of pills to prescribe. BACKGROUND: Diversion of prescription opioids is a major contributor to the rising mortality from opioid overdoses. Data to inform surgeons on the optimal dose of opioids to prescribe after common general surgical procedures is lacking. METHODS: We evaluated 642 patients undergoing 5 outpatient procedures: partial mastectomy (PM), partial mastectomy with sentinel lymph node biopsy (PM SLNB), laparoscopic cholecystectomy (LC), laparoscopic inguinal hernia repair (LIH), and open inguinal hernia repair (IH)...
September 14, 2016: Annals of Surgery
Yumi Yamaguchi, Chihiro Uejima, Yoichiro Tada, Seigo Takaya, Yutaka Yamashiro, Shunsuke Shibata, Minoru Ishiguro, Hideaki Nishidoi, Masami Kobayashi
A 46-year-old woman underwent mastectomy for right inflammatory breast cancer.Three years later, she was diagnosed with multiple bone metastases and was treated with systemic chemotherapy and zoledronic acid.Six years after the mastectomy, she complained of severe sacral pain, and 40 Gy external radiotherapy was applied to the sacral metastases.Oxycodone was also administered, but dose escalation was difficult because of severe nausea and fatigue.A bone scan showed increased uptake of Tc99m in an area consistent with the painful regions, and an injection of 89SrCl2 was administered...
September 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Paige E Tucker, Christobel Saunders, Max K Bulsara, Jason Jit-Sun Tan, Stuart G Salfinger, Helena Green, Paul A Cohen
OBJECTIVES: To investigate the prevalence of sexual dysfunction in women with a history of breast cancer following risk-reducing salpingo-oophorectomy (RRSO). A secondary objective was to examine the effect of a prior diagnosis of breast cancer, and other factors, on sexuality and quality of life (QoL) outcomes. STUDY DESIGN: Cross-sectional study of 119 women who underwent RRSO between 2009 and 2014. MAIN OUTCOME MEASURES: Data were collected via a questionnaire comprising demographic information and validated measures of sexual function, sexual distress, relationship satisfaction, body image, psychological stress, menopause symptoms and general quality of life...
September 1, 2016: Breast: Official Journal of the European Society of Mastology
Bong Gun Lee, Joon Kuk Kim, Sung Hyouk Choi, Hee Chang Ahn, Min Sung Chung
BACKGROUND: To compare shoulder morbidity between patients who received transverse rectus abdominis myocutaneous (TRAM) flaps after mastectomy (MX + TRAM) and patients who underwent mastectomy only (MX). METHODS: Thirty patients in each group were followed for a minimum of 2 postoperative years. Visual analog scale (VAS) score, restricted range of motion (ROM), rotator cuff disease, muscle strength, shoulder function scores (American Shoulder and Elbow Score and Shoulder Pain and Disability Index), measurement of scapular tilt on chest radiography and standing position in each group were compared...
August 31, 2016: ANZ Journal of Surgery
Johannes Pieter van Netten, Stephen Hoption Cann, Ian Thornton, Rory Finegan
A patient without clinical symptoms had a mammogram in October 2008. The procedure caused intense persistent pain, swelling and development of a haematoma following mediolateral left breast compression. Three months later, a 9×11 cm mass developed within the same region. Core biopsies showed a necrotizing high-grade ductal carcinoma, with a high mitotic index. Owing to its extensive size, the patient began chemotherapy followed by trastuzumab and later radiotherapy to obtain clear margins for a subsequent mastectomy...
2016: BMJ Case Reports
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