Does Pre-pectoral Reconstruction (P-PR) Reduce Early Post-operative (P-OP)And Late Neuropathic Pain (NP)?
Association of Breast Surgery ePoster Library. Soulsby R. 05/13/19; 257193; P151
Ms. Rachel Soulsby
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P151
Topic: Surgical techniques
Introduction.Pain following surgery affects 25-60% of patients. P-PR potentially reduces P-OP. We aimed to determine if we could demonstrate reduction in early P-OP and late NP.Method.Sixty-four consecutive patients undergoing immediate reconstruction participated. All sub-pectoral reconstructions (S-PR) had continuous wound infusion catheters (CWIC), the first eighteen P-PR had CWIC, and twelve had local anaesthetic via the drain only. P-PR was with Surgimed-PRS.Patient demographics, oncological and operative data were recorded. The VAS and analgesia requirements were recorded. The LANSS was completed pre-operatively and 6 months following surgery. Results: .No difference was demonstrated for age, ANC, post-operative radiotherapy, pre-operative pain or implant size (p=0.794, p=0.811, p=0.842, p=0.712, p=0.559). From 6 hours P-OP scores were lower in the P-PR group table 1. Analgesia requirements reflected pain scores. P-PR patients without CWIC initially required more paracetamol than those with CWIC (p=0.071).Time post-operatively (hours)p-value60.042120.022240.024480.0317 days0.039Table 1:p-value for the T-test comparing VAS pain scores.Scoring ≥12 on LANSS indicates likely neuropathic pain element. At 6 months, eight in the S-PR and four in the P-PR scored ≥12 (Chi-Square Test p=0.039). No difference between P-PR CWIC and non-CWIC was identified. Conclusions: .P-PR, even without CWIC, offers potential benefits of reducing P-OP and NP. P-PR patients with NP demonstrated specific point tenderness, predominantly laterally at suture sites. S-PR patient's pain was less well defined. Pain management is multifactorial. P-PR offers the potential of reducing early P-OPand improving longer term function.
Topic: Surgical techniques
Introduction.Pain following surgery affects 25-60% of patients. P-PR potentially reduces P-OP. We aimed to determine if we could demonstrate reduction in early P-OP and late NP.Method.Sixty-four consecutive patients undergoing immediate reconstruction participated. All sub-pectoral reconstructions (S-PR) had continuous wound infusion catheters (CWIC), the first eighteen P-PR had CWIC, and twelve had local anaesthetic via the drain only. P-PR was with Surgimed-PRS.Patient demographics, oncological and operative data were recorded. The VAS and analgesia requirements were recorded. The LANSS was completed pre-operatively and 6 months following surgery. Results: .No difference was demonstrated for age, ANC, post-operative radiotherapy, pre-operative pain or implant size (p=0.794, p=0.811, p=0.842, p=0.712, p=0.559). From 6 hours P-OP scores were lower in the P-PR group table 1. Analgesia requirements reflected pain scores. P-PR patients without CWIC initially required more paracetamol than those with CWIC (p=0.071).Time post-operatively (hours)p-value60.042120.022240.024480.0317 days0.039Table 1:p-value for the T-test comparing VAS pain scores.Scoring ≥12 on LANSS indicates likely neuropathic pain element. At 6 months, eight in the S-PR and four in the P-PR scored ≥12 (Chi-Square Test p=0.039). No difference between P-PR CWIC and non-CWIC was identified. Conclusions: .P-PR, even without CWIC, offers potential benefits of reducing P-OP and NP. P-PR patients with NP demonstrated specific point tenderness, predominantly laterally at suture sites. S-PR patient's pain was less well defined. Pain management is multifactorial. P-PR offers the potential of reducing early P-OPand improving longer term function.
P151
Topic: Surgical techniques
Introduction.Pain following surgery affects 25-60% of patients. P-PR potentially reduces P-OP. We aimed to determine if we could demonstrate reduction in early P-OP and late NP.Method.Sixty-four consecutive patients undergoing immediate reconstruction participated. All sub-pectoral reconstructions (S-PR) had continuous wound infusion catheters (CWIC), the first eighteen P-PR had CWIC, and twelve had local anaesthetic via the drain only. P-PR was with Surgimed-PRS.Patient demographics, oncological and operative data were recorded. The VAS and analgesia requirements were recorded. The LANSS was completed pre-operatively and 6 months following surgery. Results: .No difference was demonstrated for age, ANC, post-operative radiotherapy, pre-operative pain or implant size (p=0.794, p=0.811, p=0.842, p=0.712, p=0.559). From 6 hours P-OP scores were lower in the P-PR group table 1. Analgesia requirements reflected pain scores. P-PR patients without CWIC initially required more paracetamol than those with CWIC (p=0.071).Time post-operatively (hours)p-value60.042120.022240.024480.0317 days0.039Table 1:p-value for the T-test comparing VAS pain scores.Scoring ≥12 on LANSS indicates likely neuropathic pain element. At 6 months, eight in the S-PR and four in the P-PR scored ≥12 (Chi-Square Test p=0.039). No difference between P-PR CWIC and non-CWIC was identified. Conclusions: .P-PR, even without CWIC, offers potential benefits of reducing P-OP and NP. P-PR patients with NP demonstrated specific point tenderness, predominantly laterally at suture sites. S-PR patient's pain was less well defined. Pain management is multifactorial. P-PR offers the potential of reducing early P-OPand improving longer term function.
Topic: Surgical techniques
Introduction.Pain following surgery affects 25-60% of patients. P-PR potentially reduces P-OP. We aimed to determine if we could demonstrate reduction in early P-OP and late NP.Method.Sixty-four consecutive patients undergoing immediate reconstruction participated. All sub-pectoral reconstructions (S-PR) had continuous wound infusion catheters (CWIC), the first eighteen P-PR had CWIC, and twelve had local anaesthetic via the drain only. P-PR was with Surgimed-PRS.Patient demographics, oncological and operative data were recorded. The VAS and analgesia requirements were recorded. The LANSS was completed pre-operatively and 6 months following surgery. Results: .No difference was demonstrated for age, ANC, post-operative radiotherapy, pre-operative pain or implant size (p=0.794, p=0.811, p=0.842, p=0.712, p=0.559). From 6 hours P-OP scores were lower in the P-PR group table 1. Analgesia requirements reflected pain scores. P-PR patients without CWIC initially required more paracetamol than those with CWIC (p=0.071).Time post-operatively (hours)p-value60.042120.022240.024480.0317 days0.039Table 1:p-value for the T-test comparing VAS pain scores.Scoring ≥12 on LANSS indicates likely neuropathic pain element. At 6 months, eight in the S-PR and four in the P-PR scored ≥12 (Chi-Square Test p=0.039). No difference between P-PR CWIC and non-CWIC was identified. Conclusions: .P-PR, even without CWIC, offers potential benefits of reducing P-OP and NP. P-PR patients with NP demonstrated specific point tenderness, predominantly laterally at suture sites. S-PR patient's pain was less well defined. Pain management is multifactorial. P-PR offers the potential of reducing early P-OPand improving longer term function.
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