The preventive strategies for chronic persistent postsurgical pain following breast cancer surgery: A systematic review and meta-analysis.
4 affiliations
- 1Department of Anaesthesia, Kalyan Singh Government Medical College, Bulandshahr, Uttar Pradesh, India.
- 2Department of Anaesthesiology, Critical Care and Pain Medicine, University College of Medical Sciences and GTB Hospital, New Delhi, India.
- 3Delhi Cancer Registry, Dr. BRA Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
- 4Department of Surgical Oncology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Abstract
Introduction
Breast cancer is the most common malignant disease among women worldwide. With improved treatment, 5-year survival has increased leading to increasing number of survivors reporting chronic persistent post-surgical pain (CPPP). Hence this systematic review and meta-analysis was conducted to analyse preventive strategies in chronic persistent postsurgical pain following breast cancer surgery.Methods
Electronic databases were searched for randomized controlled trials that allocated patients undergoing breast cancer surgery to receive any intervention to prevent postsurgical pain. Data extraction was conducted by two reviewers and any discrepancy was resolved by third independent reviewer. The quality of study was assessed using the Pedro scale and risk of bias was assessed using Cochrane risk of bias. The primary outcomes of interest were patient-reported pain intensity as by the verbal rating scale (VRS), Visual analogue scale (VAS), and numerical rating scales (NRS), and incidence of chronic pain. This was assessed at 3 months and 6 months after the surgery. The association between the primary outcome and preventive strategies was analyzed using relative risk.Results
Twenty-seven studies were included. The intervention reduces the CPPP at 3-month by 36% as compared to the control group and this reduction was statistically significant [RR: 0.64: 0.54-0.75; P < 0.001; I² = 24.2%]. The heterogeneity between them was quite low I² = 24.2% with P = 0.158. Intervention group reduces the incidence of CPPP at 6 months by 40% which was also statistically significant [RR: 0.60: 0.41-0.87; P = 0.007; I² = 36.9%; P = 0.125].Conclusion
Either of the pain preventive strategies that is, pharmacotherapy and regional blocks led to a significant reduction in the incidence of CPPP at 3 months as well as 6 months.
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BibTeX
@article{khushboo2026preventive,
title = {{The preventive strategies for chronic persistent postsurgical pain following breast cancer surgery: A systematic review and meta-analysis.}},
author = {Khushboo and Saxena Ashok Kumar and K Malhotra Rajeev and Sushil Kumar},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_41_26},
url = {https://europepmc.org/article/MED/42960323},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - The preventive strategies for chronic persistent postsurgical pain following breast cancer surgery: A systematic review and meta-analysis.
AU - Khushboo
AU - Saxena Ashok Kumar
AU - K Malhotra Rajeev
AU - Sushil Kumar
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_41_26
UR - https://europepmc.org/article/MED/42960323
AB - Introduction Breast cancer is the most common malignant disease among women worldwide. With improved treatment, 5-year survival has increased leading to increasing number of survivors reporting chronic persistent post-surgical pain (CPPP). Hence this systematic review and meta-analysis was conducted to analyse preventive strategies in chronic persistent postsurgical pain following breast cancer surgery.Methods Electronic databases were searched for randomized controlled trials that allocated patients undergoing breast cancer surgery to receive any intervention to prevent postsurgical pain. Data extraction was conducted by two reviewers and any discrepancy was resolved by third independent reviewer. The quality of study was assessed using the Pedro scale and risk of bias was assessed using Cochrane risk of bias. The primary outcomes of interest were patient-reported pain intensity as by the verbal rating scale (VRS), Visual analogue scale (VAS), and numerical rating scales (NRS), and incidence of chronic pain. This was assessed at 3 months and 6 months after the surgery. The association between the primary outcome and preventive strategies was analyzed using relative risk.Results Twenty-seven studies were included. The intervention reduces the CPPP at 3-month by 36% as compared to the control group and this reduction was statistically significant [RR: 0.64: 0.54-0.75; P < 0.001; I² = 24.2%]. The heterogeneity between them was quite low I² = 24.2% with P = 0.158. Intervention group reduces the incidence of CPPP at 6 months by 40% which was also statistically significant [RR: 0.60: 0.41-0.87; P = 0.007; I² = 36.9%; P = 0.125].Conclusion Either of the pain preventive strategies that is, pharmacotherapy and regional blocks led to a significant reduction in the incidence of CPPP at 3 months as well as 6 months.
SN - 1658-354X
SN - 0975-3125
ER -