Abstract
Background and Aims:Chronic persistent postsurgical pain(CPCP) following breast cancer surgery is associated with decreased health-related quality of life and additional psychological distress.This meta-analysis aimed to evaluate the effect of various preventive strategies used for reducing the chronic persistent post-surgical pain following breast cancer surgery.Methods:An extensive search was conducted on online databases like PubMed, Google Scholar, Science Direct, and Embase. All the relevant randomised controlled trials(RCT) that are published up to June 2021 were included in this review. Patients with breast cancer who have undergone lumpectomy with or without axillary lymph node dissection and modified radical mastectomy were included in the study. The primary outcome measure was pain intensity. Incidence of chronic pain at 3 months using a verbal rating scale (VRS), visual analog scale (VAS), and numerical rating scales (NRS) were compared with control groups. The association between the primary outcome and preventive strategies was assessed using relative risk.Results:Incidence of CPSP at 3-month was assessed by 21 RCTs. This meta-analysis included 1610 patients (804 in intervention groups and 806 controls). Intervention reduced the incidence of CPSP at 3-month by 37% as compared to the control group and this reduction was statistically significant [Relative risk: 0.64: 0.54-0.75; p<0.001; I2=24.2%]. There was no publication bias and low heterogeneity among the studies (figure 1).Figure 1– Forest plot showing the results of randomised controlled trials.Conclusion:In patients undergoing breast cancer surgery, intervention in the form of block or drug reduces the incidences of CPSP at three months post-surgery
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