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Cited by 255Anesthesia and Pain ManagementCancer, Stress, Anesthesia, and Immune ResponsePain Management and Opioid Use

Multimodal Analgesia with Gabapentin and Local Anesthetics Prevents Acute and Chronic Pain After Breast Surgery for Cancer

Fassoulaki, Argyro, Triga, Argyro, Melemeni, Aikaterini, Sarantopoulos, Constantine·2005·Anesthesia & Analgesia
DOI 10.1213/01.ane.0000180200.11626.8e
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Abstract

In Brief We evaluated the effect of multimodal analgesia on acute and chronic pain after breast surgery for cancer. Fifty patients scheduled for breast cancer surgery were blindly randomized to receive gabapentin, eutectic mixture of local anesthetics cream, and ropivacaine in the wound or three placebos. Pain (visual analog scale) and analgesics were recorded in the postanesthesia care unit (PACU) 3, 6, and 9 h and 8 days after surgery. Three and 6 mo later, patients were assessed for chronic pain. The treatment group consumed less paracetamol in the PACU (469 versus 991 mg; P < 0.002) and less Lonalgal® (1.0 versus 4.4 tablets; P = 0.003) than the controls, exhibited lower visual analog scale scores at rest in the PACU (P = 0.001) and on postoperative Days 1, 3, and 5 (P = 0.040, P = 0.015, and P = 0.045, respectively), and after movement in the PACU (P = 0.001) and on postoperative Days 2, 4, and 8 (P = 0.028, P = 0.007, and P = 0.032, respectively). Three and 6 mo after surgery, 18 of 22 (82%) and 12 of 21 (57%) of the controls reported chronic pain versus 10 of 22 (45%) and 6 of 20 (30%) in the treatment group (P = 0.028 and P = 0.424, respectively); 5 of 22 and 4 of 21 of the controls required analgesics versus 0 of 22 and 0 of 20 of those treated (P = 0.048 and P = 0.107, respectively). Multimodal analgesia reduced acute and chronic pain after breast surgery for cancer. IMPLICATIONS: Patients subjected to surgery for breast cancer were randomly assigned to receive perioperatively gabapentin, ropivacaine in the operating field, and EMLA around the wound or three placebos. The multimodal analgesia reduced the analgesic requirements significantly and attenuated the acute and chronic pain after surgery when compared with the control group.

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Crossref · 10.1213/01.ane.0000180200.11626.8e

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  • In a randomized trial of 50 patients undergoing breast cancer surgery, multimodal analgesia (gabapentin, eutectic mixture of local anesthetic cream, and ropivacaine wound infiltration) significantly reduced pain and analgesic consumption at 3 months compared with placebo.

    “Fassoulaki et al. randomized 50 patients undergoing breast cancer surgery to receive gabapentin, a eutectic mixture of local anesthetic cream and ropivacaine wound infiltration, or three placebos. They found that pain and analgesic consumption was significantly less 3 months after the surgery in the multimodal analgesia group than the control [33].”

    From Chronic postsurgical pain: current evidence for prevention and management (2018) · cites this paper as [33]

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Authors
Fassoulaki, A., Triga, A., Melemeni, A., & Sarantopoulos, C.
Affiliations
  • National and Kapodistrian University of Athens (GR)
  • St Savas Hospital (GR)
  • Medical College of Wisconsin (US)
Corresponding author
  • Fassoulaki, Argyro
  • Melemeni, Aikaterini
ORCID
Fassoulaki, Argyro
Venue
Anesthesia & Analgesia
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-11
Volume
101
Issue
5
Pages
1427-1432
ISSN
0003-2999 (ISSN-L)
DOI
10.1213/01.ane.0000180200.11626.8e
OpenAlex
W1991737049
Cited by
255
References
19
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 15 · 2017: 13 · 2016: 11 · 2015: 16 · 2014: 19 · 2013: 27 · 2012: 14
FWCI
13.31
Type
journal article
Language
en
Open access
closed
Locations
  • Anesthesia & Analgesia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
multimodal analgesia, gabapentin, ropivacaine, EMLA, local anesthetics, breast cancer surgery, postoperative pain, chronic pain, postoperative analgesia, paracetamol consumption, post-anesthesia care unit, perioperative analgesia, wound infiltration, opioid-sparing analgesia, postoperative nausea and vomiting, postoperative delirium
MeSH terms
Gabapentin, Acute Disease, Adult, Amines, Analgesia, Anesthetics, Local, Breast Neoplasms, Chronic Disease, Cyclohexanecarboxylic Acids, Double-Blind Method, Female, gamma-Aminobutyric Acid, Humans, Middle Aged, Postoperative Pain

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