A review of postoperative analgesia for breast cancer surgery

Gloria S. Cheng, Brian M. Ilfeld

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


An online database search with subsequent article review was performed in order to review the various analgesic modalities for breast cancer surgery. Of 514 abstracts, 284 full-length manuscripts were reviewed. The effect of pharmacologic interventions is varied (NSAIDS, opioids, anticonvulsants, ketamine, lidocaine). Likewise, data from high-quality randomized, controlled studies on wound infiltration (including liposome encapsulated) and infusion of local anesthetic are minimal and conflicting. Conversely, abundant evidence demonstrates paravertebral blocks and thoracic epidural infusions provide effective analgesia and minimize opioid requirements, while decreasing opioid-related side effects in the immediate postoperative period. Other techniques with promising - but extremely limited - data include cervical epidural infusion, brachial plexus, interfascial plane and interpleural blocks. In conclusion, procedural interventions involving regional blocks are more conclusively effective than pharmacologic modalities in providing analgesia to patients following surgery for breast cancer.

Original languageEnglish (US)
Pages (from-to)603-618
Number of pages16
JournalPain management
Issue number6
StatePublished - Nov 1 2016
Externally publishedYes


  • breast cancer
  • mastectomy
  • paravertebral
  • postoperative pain
  • thoracic epidural

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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