JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (16) Citing Articles via Google Scholar Google Scholar Articles by Fassoulaki, A. Articles by Sarantopoulos, C. Search for Related Content PubMed PubMed Citation Articles by Fassoulaki, A. Articles by Sarantopoulos, C. Related Collections Postanesthetic Care Unit Pain Pharmacology

---

PAIN MEDICINE

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

Argyro Fassoulaki, MD, PhD, DEAA^*, Argyro Triga, MD, Aikaterini Melemeni, MD^*, and Constantine Sarantopoulos, MD, PhD, DEAA

*Department of Anesthesiology, Aretaieion Hospital, Medical School, University of Athens; Department of Anesthesiology, St. Savas Hospital, Athens, Greece; and Department of Anesthesiology, Medical College of Wisconsin, Milwaukee

Address correspondence and reprint requests to A. Fassoulaki, MD, PhD, DEAA, 57-59 Raftopoulou St., 11744 Athens, Greece. Address e-mail to afassou1{at}otenet.gr or fassoula{at}aretaieio.uoa.gr.

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.

This article has been cited by other articles:

				W. A. Macrae Chronic post-surgical pain: 10 years on Br. J. Anaesth., July 1, 2008; 101(1): 77 - 86. [Abstract] [Full Text] [PDF]

				H. J. McQuay, K. H. Poon, S. Derry, and R. A. Moore Acute pain: combination treatments and how we measure their efficacy Br. J. Anaesth., July 1, 2008; 101(1): 69 - 76. [Abstract] [Full Text] [PDF]

				V. K. F. Kong and M. G. Irwin Gabapentin: a multimodal perioperative drug? Br. J. Anaesth., December 1, 2007; 99(6): 775 - 786. [Abstract] [Full Text] [PDF]

				P. F. White, H. Kehlet, J. M. Neal, T. Schricker, D. B. Carr, F. Carli, and the Fast-Track Surgery Study Group The Role of the Anesthesiologist in Fast-Track Surgery: From Multimodal Analgesia to Perioperative Medical Care Anesth. Analg., June 1, 2007; 104(6): 1380 - 1396. [Abstract] [Full Text] [PDF]

				E. M. Tiippana, K. Hamunen, V. K. Kontinen, and E. Kalso Do Surgical Patients Benefit from Perioperative Gabapentin/Pregabalin? A Systematic Review of Efficacy and Safety Anesth. Analg., June 1, 2007; 104(6): 1545 - 1556. [Abstract] [Full Text] [PDF]

				F. Adam, C. Menigaux, D. I. Sessler, and M. Chauvin A Single Preoperative Dose of Gabapentin (800 Milligrams) Does Not Augment Postoperative Analgesia in Patients Given Interscalene Brachial Plexus Blocks for Arthroscopic Shoulder Surgery Anesth. Analg., November 1, 2006; 103(5): 1278 - 1282. [Abstract] [Full Text] [PDF]

				I. Gilron, C. P. N. Watson, C. M. Cahill, and D. E. Moulin Neuropathic pain: a practical guide for the clinician. Can. Med. Assoc. J., August 1, 2006; 175(3): 265 - 275. [Abstract] [Full Text] [PDF]

				H. Kehlet Perioperative analgesia to prevent chronic postmastectomy pain. Anesth. Analg., August 1, 2006; 103(2): 494 - 494. [Full Text] [PDF]

				A. Fassoulaki Perioperative Analgesia to Prevent Chronic Postmastectomy Pain Anesth. Analg., August 1, 2006; 103(2): 494 - 495. [Full Text] [PDF]

				I. Gilron Review article: The role of anticonvulsant drugs in postoperative pain management: a bench-to-bedside perspective: [Le role des anticonvulsivants dans le traitement de la douleur postoperatoire : perspective d'une application]. Can J Anesth, June 1, 2006; 53(6): 562 - 571. [Abstract] [Full Text] [PDF]

				A. Fassoulaki, A. Melemeni, A. Paraskeva, and G. Petropoulos Gabapentin attenuates the pressor response to direct laryngoscopy and tracheal intubation Br. J. Anaesth., June 1, 2006; 96(6): 769 - 773. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999