Background & Aims

Phantom breast syndrome (PBS) is a complex feeling of painful and non-painful sensations in the breast tissue that has been removed. There is an increasing number of breast cancer patients in last few years, however, there is improved survival rate in these patients because of early diagnosis and newer treatment methods which has benefited the survival rate in these patients. The need for good quality (QOL)of life warrants a pain free recovery. This has increased the need to find new interventions that might help patients in preventing the occurrence of Postmastectomy persistent Pain (PMPP) which occurs after surgery.
Persistent Post-mastectomy pain is a known phenomenon and can occur even after months. PBS is a component of PMPP and warrants treatment. Perioperative interventional and non-interventional treatment methods have been tried so that patient gets pain relief post mastectomy.
AIM OF STUDY- This research aimed to find the interventions that help relieve PBS

Methods

The databases of Ovid Medline, Elsevier Scopus, EMBASE were searched from inception to Feb 2023. Studies were screened for randomised control trials in female patients undergoing breast cancer debulking surgery under general anaesthesia with regional anaesthesia interventions, anaesthetic adjuvants, given systemically, topically or as a regional block to manage perioperative pain

Results

Six studies were included in the final analysis. All the studies had studied phantom breast pain as one of the outcomes. Five studies had seen the use of paravertebral block (PVB) for preventing chronic pain and prevention of phantom breast pain. Two studies, one using PVB and general anesthesia, and the other PVB with TIVA (Total Intravenous Anaesthesia) did not find the occurrence of PBS in any of their study group or placebo group. One study used intravenous ketamine to prevent phantom breast pain and did not find any difference between the study group and the placebo group and both the groups had an equal incidence of PBS. Three studies found paravertebral block to be beneficial in reducing PB pain by 12 months post-surgery. The quality of life in these patients was also improved.

Conclusions

Six studies were included in the final analysis. All the studies had studied phantom breast pain as one of the outcomes. Five studies had seen the use of paravertebral block (PVB) for preventing chronic pain and prevention of phantom breast pain. Two studies, one using PVB and general anesthesia, and the other PVB with TIVA (Total Intravenous Anaesthesia) did not find the occurrence of PBS in any of their study group or placebo group. One study used intravenous ketamine to prevent phantom breast pain and did not find any difference between the study group and the placebo group and both the groups had an equal incidence of PBS. Three studies found paravertebral block to be beneficial in reducing PB pain by 12 months post-surgery. The quality of life in these patients was also improved.

References

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Presenting Author

Deepa Kerketta Khurana

Poster Authors

DEEPA KERKETTA KHURANA

MBBS, MD, MSc

VMMC& SJH NEW DELHI

Lead Author

Sushma Bhatnagar

All India Institute of Medical Sciences, New Delhi, India

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Neuropathic Pain - Central