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 .
Perioperative Intravenous Lidocaine Decreases the Incidence of Persistent Pain After Breast Surgery
Objectives : Breast cancer surgery is associated with a high incidence of persistent postsurgical pain ( PPSP ) . The aim of this study was to evaluate the impact of intravenous ( IV ) lidocaine on acute and PPSP , analgesic requirements , and sensation abnormalities in patients undergoing surgery for breast cancer . Methods : Thirty-six patients participated in this r and omized , double-blinded study . Before induction of general anesthesia , patients received a bolus of intravenous lidocaine 1.5 mg/kg followed by a continuous infusion of lidocaine 1.5 mg/kgh ( lidocaine group ) or an equal volume of saline ( control group ) . The infusion was stopped 1 hour after the skin closure . Pain scores and analgesic consumption were recorded at 2 , 4 , 24 hours , and then daily for 1 week postoperatively . Three months later , patients were assessed for PPSP and secondary hyperalgesia . Results : Two ( 11.8 % ) patients in the lidocaine group and 9 ( 47.4 % ) patients in the control group reported PPSP at 3 months follow-up ( P=0.031 ) . McGill Pain Question naire revealed greater present pain intensity-visual analog scale in the control group ( 14.6±22.5 vs. 2.6±7.5 ; P=0.025 ) . Secondary hyperalgesia ( area of hyperalgesia/length of surgical incision ) was significantly less in the lidocaine group compared with control group ( 0.2±0.8 vs. 3.2±4.5 cm ; P=0.002 ) . The 2 groups were similar in terms of analgesic consumption during the early postoperative period . Discussion : Intravenous perioperative lidocaine decreases the incidence and severity of PPSP after breast cancer surgery . Prevention of the induction of central hyperalgesia is a potential mechanism
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 .