Post mastectomy pain syndrome
Keywords:
breast neoplasms, chronic pain, mastectomy, postoperative painAbstract
Introduction: breast cancer is the most prevalent oncological disease in women worldwide. Mastectomy is one of the main pillars of its treatment and can be associated with chronic postoperative pain with variable impact on the quality of life of patients.
Objective: to present the current knowledge on chronic post-mastectomy pain and some strategies applied for its prevention.
Methods: a bibliographic review was conducted in the SciELO, ClinicalKey, RedALyC, Scopus, PubMed, Clinical Evidence Cochrane databases and using the Google Scholar search engine. The descriptors used were: pain, postoperative pain, cancer, breast surgery. 75 articles were located between the years 2010 and 2024 in Spanish and English, 38 of which were chosen. The analytical-synthetic, historical-logical, and inductive-deductive theoretical methods were used.
Development: post-mastectomy pain syndrome includes a wide range of unpleasant and painful sensations in the arms, chest, shoulders and armpits. The main risk factors are: age, traumatic nature of the procedure, acute postoperative pain of greater intensity, depression, anxiety, among others. The neuropathic component makes its treatment difficult, so the detection of risk factors and adequate treatment of acute postoperative pain, followed by the guidelines of multimodal analgesia with the use of neuraxial and locoregional anesthesia, opioid analgesics, nonsteroidal anti-inflammatory drugs, physical and psychological therapy, are key to reducing the incidence of this syndrome.
Conclusions: chronic postoperative pain after breast surgery is a multifactorial phenomenon that significantly affects the quality of life of patients, with poor response to treatment, so the need to focus on preventive strategies should be considered. Adequate treatment of acute postoperative pain based on multimodal strategies, the use of regional techniques, opioid and non-opioid analgesics, physical and psychological therapy, are essential in reducing the incidence of pain
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