A bilateral clinical model for the study of acute and chronic pain after breast-reduction surgery

• Published in: Acta anaesthesiologica Scandinavica Vol. 45; no. 5; pp. 576 - 582
• Main Authors: Bell, R. F., Sivertsen, Å., Mowinkel, P., Vindenes, H.
• Format: Journal Article
• Language: English
• Published: Copenhagen Munksgaard International Publishers 01.05.2001; Blackwell
• Subjects: Acute Disease; Adolescent; Adult; Analgesics - therapeutic use; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; bilateral model; Biological and medical sciences; Chronic Disease; Double-Blind Method; Female; Hot Temperature; Humans; lidocaine infiltration; Local anesthesia. Pain (treatment); Mammaplasty; Medical sciences; Pain Measurement; Pain, Postoperative - diagnosis; Pain, Postoperative - drug therapy; Physical Stimulation; postoperative pain; Pre-emptive analgesia; Prospective Studies; Research Design; Sensory Thresholds; thermal thresholds; Treatment Outcome; Human; Open reduction; Acute; Bilateral; Local anesthetic; Prevention; Analgesia; Local administration; Chemotherapy; Chronic; Pain; Aesthetic surgery; Female; Organic amide; Infiltration; Mammary gland; Lidocaine
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1034/j.1399-6576.2001.045005576.x

Background: There is a need for new clinical models to investigate effectively the development of pain after surgery and the effect, if any, of pre‐emptive treatment. Bilateral models are of special interest, since the patient serves as his/her own control. The objective of this preliminary study was to test a clinical model for the study of acute and chronic pain after bilateral reduction mammoplasty. Methods: Eight patients participated in the study where the breasts were randomized to test and control groups. In each patient, one breast was preoperatively infiltrated with lidocaine and adrenaline and the other breast infiltrated with saline and adrenaline. Assessment included visual analogue scale (VAS) pain intensity, thermal thresholds, mapping for punctate hyperalgesia and tactile sensation. Assessments were made preoperatively, postoperatively and at 6 months after surgery. Results: With regard to acute postoperative pain intensity, the model demonstrated a clear difference between lidocaine and placebo treated breasts. There was no difference between lidocaine and placebo treated breasts with regard to chronic pain, but these results are inconclusive due to small number of patients. Conclusion: The model is sensitive and may be useful in studies of mechanisms of development and prevention of chronic pain after surgery.