[Preventive analgesic effect of intraoperative administration of ibuprofen-arginine on postmastectomy pain syndrome].
Identifieur interne : 000856 ( France/Analysis ); précédent : 000855; suivant : 000857[Preventive analgesic effect of intraoperative administration of ibuprofen-arginine on postmastectomy pain syndrome].
Auteurs : F. Lakdja [France] ; F. Dixmérias ; E. Bussières ; J M Fonrouge ; A. LobéraSource :
- Bulletin du cancer [ 0007-4551 ] ; 1997.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Anti-inflammatoires non stéroïdiens (usage thérapeutique), Douleur postopératoire (), Douleur postopératoire (étiologie), Femelle, Humains, Ibuprofène (analogues et dérivés), Ibuprofène (usage thérapeutique), Mastectomie (effets indésirables), Mesure de la douleur, Méthode en double aveugle, Période postopératoire, Soins peropératoires, Syndrome, Échec thérapeutique, Études de suivi, Études prospectives.
- MESH :
- analogues et dérivés : Ibuprofène.
- effets indésirables : Mastectomie.
- usage thérapeutique : Anti-inflammatoires non stéroïdiens, Ibuprofène.
- étiologie : Douleur postopératoire.
- Adulte d'âge moyen, Douleur postopératoire, Femelle, Humains, Mesure de la douleur, Méthode en double aveugle, Période postopératoire, Soins peropératoires, Syndrome, Échec thérapeutique, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Anti-Inflammatory Agents, Non-Steroidal (therapeutic use), Double-Blind Method, Female, Follow-Up Studies, Humans, Ibuprofen (analogs & derivatives), Ibuprofen (therapeutic use), Intraoperative Care, Mastectomy (adverse effects), Middle Aged, Pain Measurement, Pain, Postoperative (etiology), Pain, Postoperative (prevention & control), Postoperative Period, Prospective Studies, Syndrome, Treatment Failure.
- MESH :
- chemical , analogs & derivatives : Ibuprofen.
- chemical , therapeutic use : Anti-Inflammatory Agents, Non-Steroidal, Ibuprofen.
- adverse effects : Mastectomy.
- etiology : Pain, Postoperative.
- prevention & control : Pain, Postoperative.
- Double-Blind Method, Female, Follow-Up Studies, Humans, Intraoperative Care, Middle Aged, Pain Measurement, Postoperative Period, Prospective Studies, Syndrome, Treatment Failure.
Abstract
The efficacy of preemptive analgesia on postoperative pain is discussed. From experimental neurophysiological data, the present policy of preventive analgesia aims at precluding modifications of the nervous system secondary to a nervous lesion and the appearance of chronic pain, particularly of the neurogenic kind. The post-mastectomy pain syndrome (PMPS) falls within the realm of neurogenic pain and is still poorly understood and underestimated. This study evaluated the preemptive effect of a perioperative administration of an oral non steroid anti-inflammatory, the ibuprofen-arginine, on PMPS. Thirty patients scheduled for partial or total mastectomy with axillary dissection were prospectively and randomly assigned to 2 groups. The ibuprofen-arginine group (group I) (n = 15), received an oral administration of 400 mg of ibuprofen-arginine, 90 min before surgery, 2 h after surgery and then every 8 h in the first 32 postoperative hours. The control group (group C) received in doubled blind a placebo at the same time. At 6 months, we looked after pain or dysesthesia. We confirmed the diagnosis of PMPS in presence of association of diagnosis criterias. Fourteen patients in each group have been included. Eighty-six percent of the patients (13 patients in group I and 11 patients in group C) presented at 6 months dysesthesia of the upper member ipsilateral to the mastectomy and/or the operated breast, appearing either immediately or after a laps of time. Nine patients (group I) and 6 patients (group C) had PMPS. Postoperative radiotherapy and lymphoedema were statistically associated with PMPS (p = 0.019 and p = 0.011). The perioperative preventive administration of a non-steroid anti-inflammatory drug reduces neither the incidence of pain in the first post-operative months, nor the appearance of PMPS at 6 months. These results suggest that others factors than the nervous lesion may play a role in the occurrence of PMPS, as radiotherapy, lymphoedema, but also psychosocials factors.
PubMed: 9207871
Affiliations:
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pubmed:9207871Le document en format XML
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Lakdja</name><affiliation wicri:level="3"><nlm:affiliation>Institut Bergonié, Service d'anesthésie-réanimation-algologie, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut Bergonié, Service d'anesthésie-réanimation-algologie, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Dixmerias, F" sort="Dixmerias, F" uniqKey="Dixmerias F" first="F" last="Dixmérias">F. Dixmérias</name></author><author><name sortKey="Bussieres, E" sort="Bussieres, E" uniqKey="Bussieres E" first="E" last="Bussières">E. Bussières</name></author><author><name sortKey="Fonrouge, J M" sort="Fonrouge, J M" uniqKey="Fonrouge J" first="J M" last="Fonrouge">J M Fonrouge</name></author><author><name sortKey="Lobera, A" sort="Lobera, A" uniqKey="Lobera A" first="A" last="Lobéra">A. Lobéra</name></author></analytic><series><title level="j">Bulletin du cancer</title><idno type="ISSN">0007-4551</idno><imprint><date when="1997" type="published">1997</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)</term><term>Double-Blind Method</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Ibuprofen (analogs & derivatives)</term><term>Ibuprofen (therapeutic use)</term><term>Intraoperative Care</term><term>Mastectomy (adverse effects)</term><term>Middle Aged</term><term>Pain Measurement</term><term>Pain, Postoperative (etiology)</term><term>Pain, Postoperative (prevention & control)</term><term>Postoperative Period</term><term>Prospective Studies</term><term>Syndrome</term><term>Treatment Failure</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Anti-inflammatoires non stéroïdiens (usage thérapeutique)</term><term>Douleur postopératoire ()</term><term>Douleur postopératoire (étiologie)</term><term>Femelle</term><term>Humains</term><term>Ibuprofène (analogues et dérivés)</term><term>Ibuprofène (usage thérapeutique)</term><term>Mastectomie (effets indésirables)</term><term>Mesure de la douleur</term><term>Méthode en double aveugle</term><term>Période postopératoire</term><term>Soins peropératoires</term><term>Syndrome</term><term>Échec thérapeutique</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Ibuprofen</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Inflammatory Agents, Non-Steroidal</term><term>Ibuprofen</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Mastectomy</term></keywords><keywords scheme="MESH" qualifier="analogues et dérivés" xml:lang="fr"><term>Ibuprofène</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Mastectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Pain, Postoperative</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Pain, Postoperative</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anti-inflammatoires non stéroïdiens</term><term>Ibuprofène</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Douleur postopératoire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Double-Blind Method</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Intraoperative Care</term><term>Middle Aged</term><term>Pain Measurement</term><term>Postoperative Period</term><term>Prospective Studies</term><term>Syndrome</term><term>Treatment Failure</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Douleur postopératoire</term><term>Femelle</term><term>Humains</term><term>Mesure de la douleur</term><term>Méthode en double aveugle</term><term>Période postopératoire</term><term>Soins peropératoires</term><term>Syndrome</term><term>Échec thérapeutique</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The efficacy of preemptive analgesia on postoperative pain is discussed. From experimental neurophysiological data, the present policy of preventive analgesia aims at precluding modifications of the nervous system secondary to a nervous lesion and the appearance of chronic pain, particularly of the neurogenic kind. The post-mastectomy pain syndrome (PMPS) falls within the realm of neurogenic pain and is still poorly understood and underestimated. This study evaluated the preemptive effect of a perioperative administration of an oral non steroid anti-inflammatory, the ibuprofen-arginine, on PMPS. Thirty patients scheduled for partial or total mastectomy with axillary dissection were prospectively and randomly assigned to 2 groups. The ibuprofen-arginine group (group I) (n = 15), received an oral administration of 400 mg of ibuprofen-arginine, 90 min before surgery, 2 h after surgery and then every 8 h in the first 32 postoperative hours. The control group (group C) received in doubled blind a placebo at the same time. At 6 months, we looked after pain or dysesthesia. We confirmed the diagnosis of PMPS in presence of association of diagnosis criterias. Fourteen patients in each group have been included. Eighty-six percent of the patients (13 patients in group I and 11 patients in group C) presented at 6 months dysesthesia of the upper member ipsilateral to the mastectomy and/or the operated breast, appearing either immediately or after a laps of time. Nine patients (group I) and 6 patients (group C) had PMPS. Postoperative radiotherapy and lymphoedema were statistically associated with PMPS (p = 0.019 and p = 0.011). The perioperative preventive administration of a non-steroid anti-inflammatory drug reduces neither the incidence of pain in the first post-operative months, nor the appearance of PMPS at 6 months. These results suggest that others factors than the nervous lesion may play a role in the occurrence of PMPS, as radiotherapy, lymphoedema, but also psychosocials factors.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Aquitaine</li><li>Nouvelle-Aquitaine</li></region><settlement><li>Bordeaux</li></settlement></list><tree><noCountry><name sortKey="Bussieres, E" sort="Bussieres, E" uniqKey="Bussieres E" first="E" last="Bussières">E. Bussières</name><name sortKey="Dixmerias, F" sort="Dixmerias, F" uniqKey="Dixmerias F" first="F" last="Dixmérias">F. Dixmérias</name><name sortKey="Fonrouge, J M" sort="Fonrouge, J M" uniqKey="Fonrouge J" first="J M" last="Fonrouge">J M Fonrouge</name><name sortKey="Lobera, A" sort="Lobera, A" uniqKey="Lobera A" first="A" last="Lobéra">A. Lobéra</name></noCountry><country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Lakdja, F" sort="Lakdja, F" uniqKey="Lakdja F" first="F" last="Lakdja">F. 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