One year follow-up on a randomized study investigating serratus anterior muscle and pectoral nerves type I block to reduced neuropathic pain descriptors after mastectomy

Author(s):Show less -

Flores, Eva M. M. ; Gouveia, Flavia V. V. ; Matsumoto, Marcio ; Bonacif, Tomas H. F. S. ; Kuroki, Mayra A. A. ; Antunes, Geiza Fernanda ; Campos, Ana Carolina P. ; Kimachi, Pedro P. P. ; Campos, Diego O. O. ; Simoes, Claudia M. M. ; Sampaio, Marcelo M. C. ; Andrade, Felipe E. M. ; Valverde, Joao ; Barros, Alfredo C. S. D. ; Pagano, Rosana L. L. ; Martinez, Raquel C. R.

• Document type: Journal article
• Source: SCIENTIFIC REPORTS; v. 13, n. 1, p. 12-pg., 2023-03-21.

Abstract

Breast cancer is the second most common diagnosed type of cancer in women. Chronic neuropathic pain after mastectomy occurs frequently and is a serious health problem. In our previous single-center, prospective, randomized controlled clinical study, we demonstrated that the combination of serratus anterior plane block (SAM) and pectoral nerve block type I (PECS I) with general anesthesia reduced acute postoperative pain. The present report describes a prospective follow-up study of this published study to investigate the development of chronic neuropathic pain 12 months after mastectomy by comparing the use of general anesthesia alone and general anesthesia with SAM + PECS I. Additionally, the use of analgesic medication, quality of life, depressive symptoms, and possible correlations between plasma levels of interleukin (IL)-1 beta, IL-6, and IL-10 collected before and 24 h after surgery as predictors of pain and depression were evaluated. The results showed that the use of SAM + PECS I with general anesthesia reduced numbness, hypoesthesia to touch, the incidence of patients with chronic pain in other body regions and depressive symptoms, however, did not significantly reduce the incidence of chronic neuropathic pain after mastectomy. Additionally, there was no difference in the consumption of analgesic medication and quality of life. Furthermore, no correlation was observed between IL-1 beta, IL-6, and IL-10 levels and pain and depression. The combination of general anesthesia with SAM + PECS I reduced the occurrence of specific neuropathic pain descriptors and depressive symptoms. These results could promote the use of SAM + PECS I blocks for the prevention of specific neuropathic pain symptoms after mastectomy. (AU)

• FAPESP's process: 11/08575-7 - The role of dopaminergic modulation in the lateral nucleus of amygdala during active avoidance response
• Grantee: Raquel Chacon Ruiz Martinez
• Support Opportunities: Research Grants - Young Investigators Grants