Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia

Background. Acute postoperative pain (APP) has a high incidence in breast surgery, and opioids are the most commonly used drugs for its management; however, they are not free from systemic side effects, which may increase comorbidity. In the past few years, opioid-free anaesthesia has been favoured...

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Main Authors: Mirian López, María Luz Padilla, Blas García, Javier Orozco, Ana María Rodilla
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2021/3290289
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author Mirian López
María Luz Padilla
Blas García
Javier Orozco
Ana María Rodilla
author_facet Mirian López
María Luz Padilla
Blas García
Javier Orozco
Ana María Rodilla
author_sort Mirian López
collection DOAJ
description Background. Acute postoperative pain (APP) has a high incidence in breast surgery, and opioids are the most commonly used drugs for its management; however, they are not free from systemic side effects, which may increase comorbidity. In the past few years, opioid-free anaesthesia has been favoured with promising results. Methods. We conducted a descriptive study including 71 patients who underwent breast cancer surgery. The opioid group (n = 41) received fentanyl for induction, remifentanil for maintenance, and rescue morphine before waking up, whereas the ketamine group (n = 30) received a ketamine bolus for induction followed by continuous ketamine infusion during surgery. Later, the presence and intensity of pain were registered, using the Numeric Rating Scale (NRS 1–10) for pain, at different times in the recovery room, at 24 hours and at 3 months. Results. Administration of ketamine is more effective than opioid use for APP prevention in breast cancer surgery because the ketamine group presented with less pain than the opioid group (p < 0.05) at all measured times. When there was pain, patients in the ketamine group gave a lower score to its intensity (p < 0.05). Conclusions. Ketamine could reduce the incidence of APP in breast cancer surgery, compared to opioids.
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spelling doaj-art-3a464b35691e401d9c14eeec13b45e272025-08-20T03:55:37ZengWileyPain Research and Management1918-15232021-01-01202110.1155/2021/3290289Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory AnalgesiaMirian López0María Luz Padilla1Blas García2Javier Orozco3Ana María Rodilla4Department of AnesthesiaDepartment of AnesthesiaDepartment of AnesthesiaDepartment of AnesthesiaDepartment of AnesthesiaBackground. Acute postoperative pain (APP) has a high incidence in breast surgery, and opioids are the most commonly used drugs for its management; however, they are not free from systemic side effects, which may increase comorbidity. In the past few years, opioid-free anaesthesia has been favoured with promising results. Methods. We conducted a descriptive study including 71 patients who underwent breast cancer surgery. The opioid group (n = 41) received fentanyl for induction, remifentanil for maintenance, and rescue morphine before waking up, whereas the ketamine group (n = 30) received a ketamine bolus for induction followed by continuous ketamine infusion during surgery. Later, the presence and intensity of pain were registered, using the Numeric Rating Scale (NRS 1–10) for pain, at different times in the recovery room, at 24 hours and at 3 months. Results. Administration of ketamine is more effective than opioid use for APP prevention in breast cancer surgery because the ketamine group presented with less pain than the opioid group (p < 0.05) at all measured times. When there was pain, patients in the ketamine group gave a lower score to its intensity (p < 0.05). Conclusions. Ketamine could reduce the incidence of APP in breast cancer surgery, compared to opioids.http://dx.doi.org/10.1155/2021/3290289
spellingShingle Mirian López
María Luz Padilla
Blas García
Javier Orozco
Ana María Rodilla
Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia
Pain Research and Management
title Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia
title_full Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia
title_fullStr Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia
title_full_unstemmed Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia
title_short Prevention of Acute Postoperative Pain in Breast Cancer: A Comparison between Opioids versus Ketamine in the Intraoperatory Analgesia
title_sort prevention of acute postoperative pain in breast cancer a comparison between opioids versus ketamine in the intraoperatory analgesia
url http://dx.doi.org/10.1155/2021/3290289
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