Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
[Preventive analgesic effect of intraoperative administration of ibuprofen-arginine on postmastectomy pain syndrome].
The efficacy of preemptive analgesia on postoperative pain is discussed . From experimental neurophysiological data , the present policy of preventive analgesia aims at precluding modifications of the nervous system secondary to a nervous lesion and the appearance of chronic pain , particularly of the neurogenic kind . The post-mastectomy pain syndrome ( PMPS ) falls within the realm of neurogenic pain and is still poorly understood and underestimated . This study evaluated the preemptive effect of a perioperative administration of an oral non steroid anti-inflammatory , the ibuprofen-arginine , on PMPS . Thirty patients scheduled for partial or total mastectomy with axillary dissection were prospect ively and r and omly assigned to 2 groups . The ibuprofen-arginine group ( group I ) ( n = 15 ) , received an oral administration of 400 mg of ibuprofen-arginine , 90 min before surgery , 2 h after surgery and then every 8 h in the first 32 postoperative hours . The control group ( group C ) received in doubled blind a placebo at the same time . At 6 months , we looked after pain or dysesthesia . We confirmed the diagnosis of PMPS in presence of association of diagnosis criteria s. Fourteen patients in each group have been included . Eighty-six percent of the patients ( 13 patients in group I and 11 patients in group C ) presented at 6 months dysesthesia of the upper member ipsilateral to the mastectomy and /or the operated breast , appearing either immediately or after a laps of time . Nine patients ( group I ) and 6 patients ( group C ) had PMPS . Postoperative radiotherapy and lymphoedema were statistically associated with PMPS ( p = 0.019 and p = 0.011 ) . The perioperative preventive administration of a non-steroid anti-inflammatory drug reduces neither the incidence of pain in the first post-operative months , nor the appearance of PMPS at 6 months . These results suggest that others factors than the nervous lesion may play a role in the occurrence of PMPS , as radiotherapy , lymphoedema , but also psychosocials factors
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .