Impact of Perioperative Hypnosedation on Postmastectomy Chronic Pain: Preliminary Results

• Main Authors: Camille Lacroix MD, Francois P. Duhoux MD, PhD, Julie Bettendorff MD, Christine Watremez MD, PhD, Fabienne Roelants MD, Marie-Agnes Docquier MD, PhD, Arnaud Potié MD, Maude Coyette MD, Amandine Gerday MD, Vasiliki Samartzi MD, Philippe Piette MD, Nathan Piette MD, Martine Berliere MD, PhD
• Format: Article
• Language: English
• Published: SAGE Publishing 2019-08-01
• Series: Integrative Cancer Therapies
• Online Access: https://doi.org/10.1177/1534735419869494

Objectives: The main aim of this prospective nonrandomized study was to evaluate if mastectomy performed with perioperative hypnosedation led to a lower incidence of chronic pain compared with mastectomy under general anesthesia. Methods: Forty-two breast cancer patients who underwent mastectomy either under GA (GA group, n = 21) or HYP (HYP group, n = 21) associated with local and/or regional anesthesia were included. The type of adjuvant therapy as well as the number of reconstructive surgical procedures were well balanced between the 2 groups. The average age of the patients and the type of axillary surgery were also equivalent. Incidence of postmastectomy chronic pain, lymphedema, and shoulder range of motion (ROM) were evaluated after a mean 4-year follow-up. Results: The study shows a statistically significant lower incidence of postmastectomy chronic pain in HYP group (1/21, 1 patient out of 21 experiencing pain) compared with GA group (9/21) with 9 patients out of 21 experiencing pain ( P = .008). ROM for shoulder was also less frequently affected in the hypnosedation group, as only 1 patient had decreased ROM, instead of 7 in the other group ( P = .04). Conclusions: Our study is the first to hint at the potential benefits of hypnosedation on postmastectomy chronic pain. Despite the limitations of this study (nonrandomized, small sample), preliminary results merit further study of hypnosedation.