Akbas Ahmet, Dagmura Hasan, Daldal Emin, Dasiran Fatih Mehmet, Deveci Hülya, Okan Ismail
Department of General Surgery, Surgical Oncology Center, Gaziosmanpaşa University School of Medicine, Tokat, Turkey.
Department of General Surgery, Tokat Gaziosmanpaşa University, Tokat, Turkey.
Breast Care (Basel). 2021 Feb;16(1):66-71. doi: 10.1159/000506922. Epub 2020 Apr 14.
Prolonged survival period as a result of early diagnosis and treatment in breast cancer has increased the importance of postoperative morbidities. The aim of the present study was to investigate the association of pain ca-tastrophizing with shoulder pain in patients with decreased shoulder range of motion in the postoperative period.
The present study included 53 patients who underwent surgery due to breast cancer. Patients who had bilateral mastectomy, distant metastases, cervical-cranial originated lesions, patients with problems involving one of the shoulders or upper extremities before the operation, and patients with cognitive impairment, heart failure, or low albumin levels (liver parenchyma disease or renal failure) were excluded. Shoulder range of motion was measured in the postoperative period, and two study groups were established: one with a limited shoulder range of motion level and the other with a normal level. Effects of pain catastrophizing and shoulder pain severity on shoulder range of motion limitation were compared between the two groups.
The average age of 53 female patients who had breast surgery was 52.3 ± 10.5 years. In the group with limited shoulder range of motion, the median pain catastrophizing scale value was 27 (range 5-32) and the shoulder pain severity score was 4 (range 0-8), while in the group with normal shoulder range of motion these values were 11 (range 3-39) and 2 (range 0-6), respectively ( < 0.05). In addition, it was found that factors such as surgical treatment modality and postoperative radiotherapy did not significantly affect shoulder range of motion limitation.
Determining the pain catastrophizing scale of patients and controlling pain in the early postoperative period could have positive effects on shoulder range of motion.
乳腺癌早期诊断和治疗使生存期延长,术后并发症的重要性增加。本研究旨在探讨疼痛灾难化与术后肩关节活动范围减小患者肩部疼痛之间的关联。
本研究纳入53例因乳腺癌接受手术的患者。排除双侧乳房切除术、远处转移、头颈源性病变、术前肩部或上肢存在问题的患者,以及认知障碍、心力衰竭或白蛋白水平低(肝实质疾病或肾衰竭)的患者。术后测量肩关节活动范围,并设立两个研究组:一组肩关节活动范围受限,另一组正常。比较两组疼痛灾难化和肩部疼痛严重程度对肩关节活动范围受限的影响。
53例接受乳房手术的女性患者平均年龄为52.3±10.5岁。肩关节活动范围受限组的疼痛灾难化量表中位值为27(范围5 - 32),肩部疼痛严重程度评分为4(范围0 - 8),而肩关节活动范围正常组的这些值分别为11(范围3 - 39)和2(范围0 - 6)(<0.05)。此外,发现手术治疗方式和术后放疗等因素对肩关节活动范围受限无显著影响。
确定患者的疼痛灾难化量表并在术后早期控制疼痛,可能对肩关节活动范围产生积极影响。