Review article
Analgesia after surgery for breast tumor
Gordana Brozović
; Department of Anesthesiology, University Hospital for Tumors, Zagreb,Croatia
Danko Velimir Vrdoljak
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Vesna Ramljak
; Department of Clinical Cytology, University Hospital for Tumors, Zagreb,Croatia
Abstract
The choice of appropriate premedication and anesthetic technique may contribute to better postoperative analgesia. Intensity, frequency of occurrence, quality and duration of pain differ regarding the type of surgery: extent, site and duration of surgical procedure. They also depend on the patient's psychological profile, his perioperative psychological and physiological adaptation and the quality of postoperative procedures. Pain after mastectomy and evacuation of axillary lymph nodes is classified as moderate in nearly half of the patients, however, 10-30% of them may experience severe pain. In the management of postoperative pain, opioid and nonopiod analgesics are used. Poorly treated pain after surgery may be considered a significant factor for increased morbidity and mortality resulting in a protracted hospital stay and, subsequently, increased treatment costs. The intensity of chronic pain, that might occur in a form of phatnom pain in the chest, shoulder and upper arm region following breast surgery, greatly depends on good surgical technique, successful management of acute postoperative pain, and well-performed radiotherapy, chemotherapy and physical therapy. Prolonged pain with adverse effects on the respiratory, cardiocirculatory and neuroendocrine function, may lead to psychological disorders, i.e. depression, and produce long-term effects in the central and peripheral nervous system. Pain therapy should therefore be included in a so-called multimodal concept of postoperative rehabilitation.
Keywords
Hrčak ID:
281801
URI
Publication date:
3.12.2003.
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