Acute and persistent postoperative pain after breast surgery

Karamarie Fecho, Natalie R. Miller, Sarah A. Merritt, Nancy Klauber-Demore, C. Scott Hultman, William S. Blau

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


Objectives. This study's primary aim was to determine levels of acute and persistent postoperative pain and the incidence of severe postoperative pain after mastectomy. A secondary aim was to examine factors associated with postoperative pain. Design. A retrospective cohort study of 196 female breast surgery subjects was conducted. Data were collected on: numerical rating scale (NRS) pain scores in the Post Anesthesia Care Unit (PACU) and at 1 month and 6-12 months postoperative; age; race; insurance; obesity; radiotherapy; chemotherapy; hypertension; anesthesia care time; and intraoperative and PACU opioid use. Severe postoperative pain was defined as NAS ≥ 5. Data were analyzed using chi square, Fisher's exact test or analysis of variance, with α = 0.05. Results. PACU pain and the incidence of severe PACU pain increased with surgical complexity (P < 0.005). PACU pain scores averaged 4.71 ± 0.24 and 57.7% of subjects experienced severe pain. Postoperative pain scores at 1 or 6-12 months did not vary by surgical complexity and averaged 2.21 ± 0.32 and 0.74 ± 0.22, respectively. Severe postoperative pain was experienced by 22.1% of subjects at 1 month and 8.2% of subjects at 6-12 months. Older age and systolic hypertension were associated with less PACU pain. Non-White race, obesity, and high PACU opioid use were associated with greater postoperative pain at 1 month. Non-White people also had greater postoperative pain at 6-12 months. Conclusions. The results suggest that nearly 60% of breast surgery patients experience severe acute postoperative pain, with severe pain persisting for 6-12 months in almost 10% of patients.

Original languageEnglish (US)
Pages (from-to)708-715
Number of pages8
JournalPain Medicine
Issue number4
StatePublished - 2009
Externally publishedYes


  • Acute pain
  • Breast reconstruction
  • Mastectomy
  • Persistent pain
  • Postoperative pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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