Fabrício T Mendonça, Larissa Ferreira Cunha Nascimento, Nathalia Mundoco Veloso, Gabriela Cavalcante Pires Basto
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Secondary outcomes included neuropathic pain (score ≥4 in the Douleur Neuropathique 4 questionnaire), use of analgesic/anti-inflammatory drugs, pain intensity through the short-form McGill Pain Questionnaire, and type, frequency, and location of the pain.</p><p><strong>Results: </strong>Of the 60 patients that completed the 24-hour follow-up (short-term trial), 53 (88%) completed the long-term follow-up (27 in the PSPB group and 26 in the placebo group). Six of 27 patients (22%) in the PSPB group and 17 of 26 patients (65%) in the placebo group reported any chronic pain (relative risk [RR], 0.34; 95% confidence interval [95% CI]=0.16-0.73, P =0.005). The risk of neuropathic pain was also lower in the PSPB group than in the placebo group (18.5% vs. 54%, respectively; RR, 0.34; 95% CI=0.14-0.82, P =0.02). There were no differences regarding all other pain-related outcomes considering the patients who developed PMPS.</p><p><strong>Discussion: </strong>The results suggest that, in the long term, PSPB-treated participants were associated with a statistically significantly lower risk of PMPS than those who received standard general anesthesia.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT03966326).</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":"39 7","pages":"334-339"},"PeriodicalIF":2.6000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term Efficacy of Pectoserratus Plane Block (PSPB) for Prevention of Post-mastectomy Pain Syndrome: Extended Follow-up From a Randomized Controlled Trial.\",\"authors\":\"Fabrício T Mendonça, Larissa Ferreira Cunha Nascimento, Nathalia Mundoco Veloso, Gabriela Cavalcante Pires Basto\",\"doi\":\"10.1097/AJP.0000000000001118\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Pectoserratus plane block (PSPB) leads to lower postoperative pain intensity. We examined whether PSPB could also reduce the incidence of post-mastectomy pain syndrome (PMPS) in women undergoing breast cancer surgery.</p><p><strong>Methods: </strong>We performed an extension study of a randomized trial that compared PSPB versus control in women undergoing mastectomy. The primary outcome was any chronic pain at the surgical site or adjacent areas, defined as persistent/recurrent pain lasting ≥3 months. Secondary outcomes included neuropathic pain (score ≥4 in the Douleur Neuropathique 4 questionnaire), use of analgesic/anti-inflammatory drugs, pain intensity through the short-form McGill Pain Questionnaire, and type, frequency, and location of the pain.</p><p><strong>Results: </strong>Of the 60 patients that completed the 24-hour follow-up (short-term trial), 53 (88%) completed the long-term follow-up (27 in the PSPB group and 26 in the placebo group). 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引用次数: 0
摘要
目的:胸锯肌平面阻滞(PSPB)可降低术后疼痛强度。我们研究了PSPB是否也可以降低乳腺癌手术妇女乳房切除术后疼痛综合征(PMPS)的发生率。方法:我们进行了一项随机试验的扩展研究，比较PSPB与对照组在接受乳房切除术的妇女中。主要结局是手术部位或邻近区域的任何慢性疼痛，定义为持续/复发性疼痛持续≥3个月。次要结局包括神经性疼痛(Douleur neuropathque 4问卷评分≥4分)、镇痛/抗炎药物的使用、McGill疼痛问卷(short-form pain questionnaire)的疼痛强度、疼痛类型、频率和部位。结果:60例患者完成24小时随访(短期试验)，53例(88%)完成长期随访(PSPB组27例，安慰剂组26例)。PSPB组27例患者中有6例(22%)报告有慢性疼痛，安慰剂组26例患者中有17例(65%)报告有慢性疼痛(相对风险[RR]， 0.34;95%置信区间[95% CI]=0.16-0.73, P =0.005)。PSPB组发生神经性疼痛的风险也低于安慰剂组(分别为18.5%和54%;RR 0.34;95% ci =0.14-0.82, p =0.02)。考虑到患有ppmps的患者，所有其他与疼痛相关的结果没有差异。讨论:结果表明，从长期来看，pspb治疗的参与者与接受标准全身麻醉的参与者相比，psps的风险有统计学意义上的显著降低。试验注册:ClinicalTrials.gov (NCT03966326)。
Long-term Efficacy of Pectoserratus Plane Block (PSPB) for Prevention of Post-mastectomy Pain Syndrome: Extended Follow-up From a Randomized Controlled Trial.
Objectives: Pectoserratus plane block (PSPB) leads to lower postoperative pain intensity. We examined whether PSPB could also reduce the incidence of post-mastectomy pain syndrome (PMPS) in women undergoing breast cancer surgery.
Methods: We performed an extension study of a randomized trial that compared PSPB versus control in women undergoing mastectomy. The primary outcome was any chronic pain at the surgical site or adjacent areas, defined as persistent/recurrent pain lasting ≥3 months. Secondary outcomes included neuropathic pain (score ≥4 in the Douleur Neuropathique 4 questionnaire), use of analgesic/anti-inflammatory drugs, pain intensity through the short-form McGill Pain Questionnaire, and type, frequency, and location of the pain.
Results: Of the 60 patients that completed the 24-hour follow-up (short-term trial), 53 (88%) completed the long-term follow-up (27 in the PSPB group and 26 in the placebo group). Six of 27 patients (22%) in the PSPB group and 17 of 26 patients (65%) in the placebo group reported any chronic pain (relative risk [RR], 0.34; 95% confidence interval [95% CI]=0.16-0.73, P =0.005). The risk of neuropathic pain was also lower in the PSPB group than in the placebo group (18.5% vs. 54%, respectively; RR, 0.34; 95% CI=0.14-0.82, P =0.02). There were no differences regarding all other pain-related outcomes considering the patients who developed PMPS.
Discussion: The results suggest that, in the long term, PSPB-treated participants were associated with a statistically significantly lower risk of PMPS than those who received standard general anesthesia.
期刊介绍：
The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.
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