Cancer Surgery Anesthesia and Chronic Pain

Breast cancer patients given propofol had less long term chronic pain than those given sevoflurane

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Breast cancer patients who undergo a mastectomy (removal of breast) can have pain for years after the surgery. Does the medication given during surgery make a difference?

Researchers have found that the type of anesthesia used during the operation may impact the development of long-term pain.

Breast cancer patients given the anesthesia propofol (Diprivan) during mastectomy surgery were 50 percent less likely to experience chronic pain as patients who were given sevoflurane (Sojourn and Ultane).

"Ask what type of anesthesia you’ll be given during surgery."

Dr. Ah-Reum Cho, of the Pusan National University in Busan, Korea, led the study that compared the results of 175 women given either propofol or sevoflurane. Both of these medicines are commonly used during surgery to render the patient unconscious.

Researchers followed up with the women four years after surgery and found that 56 percent reported having chronic pain.

Study members completed a questionnaire that asked if pain interfered with mobility, self-care and daily activities or work.

Women who were given propofol were less likely than those given sevoflurane to have long-term pain – 44 percent compared to 67 percent, respectively.

Even when other factors were considered, women who were given sevoflurane were roughly 50 percent more likely to have pain years after surgery than those given propofol.

For women who reported pain, the type of anesthesia did not impact severity or how long the pain lasted.

The study found that those at greatest risk for chronic pain tended to be younger women who had more extensive disease that required more complex surgery including the removal of lymph nodes in the armpit.

Also, women who needed more morphine for pain relief immediately after the surgery were more prone to experience long-lasting pain. In fact, morphine use after surgery was a risk factor for long-lasting pain.  

“This study suggests that anesthetics during breast cancer surgery may affect the development of chronic pain. Further prospective studies are needed to confirm the validity of these provocative findings,” the authors wrote.

This report was published in the March issue of Anesthesia & Analgesia. No conflicts of interest were disclosed.

Reviewed by: 
Review Date: 
March 5, 2013
Last Updated:
March 6, 2013