Development of a Personalised Care Plan Designed to Reduce Chronic Post-Operative Pain Following Breast Surgery
Persistent Post-surgical Pain, Neuropathic Pain, Cancer Pain
About this trial
This is an interventional prevention trial for Persistent Post-surgical Pain focused on measuring Persistent post-surgical pain, Breast surgery, Complex intervention, Pain treatment
Eligibility Criteria
Inclusion Criteria:
- Women aged 18 and over with breast cancer undergoing breast surgery at the Royal Marsden Hospital. This includes mastectomy, wide local excision with axillary clearance, breast reconstruction surgery i.e Diep flap, LD flap
Exclusion Criteria:
- Previous thoracic surgery.
- Symptomatic angina pectoris.
- Renal impairment.
- Inability to read or to understand consent documentation.
- Patients undergoing the following surgery; lumpectomy, wide local excision, cosmetic procedures, any day-case breast surgery.
Sites / Locations
- The Royal Marsden Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Intervention limb
Usual care
Medical review and analgesic optimisation. Pain education (in the form of leaflet and website recommendations) Psychological input for patients with evidence of psychological morbidity. Protective analgesia - one pre-procedure dose of 150mg oral pregabalin. Five days post-procedure oral pregablin twice daily at a dose of 75mg twice a day. Patients offered a paravertebral block, local anaesthetic infiltrated around the wound by the surgeon. Daily, focused visits from the hospital pain team. Any patient displaying concerning pain symptoms, behaviour or who underwent prolonged (>3 hours surgery) may be booked for early 'preemptive' review in pain clinic.
These partcipants will receive usual care before, during and after their breast surgery