title: General anaesthetic agents do not influence persistent pain after breast cancer surgery: A prospective nationwide cohort study.
abstract: BACKGROUND
  It has recently been suggested that propofol exerts a protective effect on the occurrence of persistent pain after breast cancer surgery. We analysed data from a subcohort taken from a multicentre study to validate this information.
  
  
  OBJECTIVE
  The objective of this article is to study the role of the agent used for maintenance of general anaesthesia on the occurrence of persistent pain, with adjustment for multiple pre and peri-operative variables using the generalised linear model.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Four French university hospitals.
  
  
  METHODS
  Three hundred and twenty-eight and 362 patients with full dataset, depending on the studied outcome.
  
  
  METHODS
  Questionnaires sent at the third and the sixth month after surgery.
  
  
  METHODS
  The risk of persistent postsurgical neuropathic pain (defined by the DN4 questionnaire) within 6 months after surgery, and the intensity of persistent pain at the sixth month.
  
  
  RESULTS
  Axillary lymph node harvesting and previous history of peripheral neuropathy were independent risk factors of persistent postsurgical neuropathic pain, although older age was protective. The same independent risk factors, but not age, explained the intensity of persistent postsurgical pain at the sixth month after surgery. We did not find any effect of the general anaesthetic, whether halogenated agent or propofol, using either unadjusted or adjusted analyses based on covariates or propensity score.
  
  
  CONCLUSIONS
  There does not appear to be a role for the anaesthetic protocol in the occurrence of persistent postsurgical pain. Other already well established hypotheses were confirmed.
  
  
  BACKGROUND
  ClinicalTrials.gov (ref. NCT00812734).
authors.affiliation: From the Centre Oscar-Lambret, Département d'Anesthésie-Réanimation-Algologie, Lille (DL-K), CHU Clermont-Ferrand, Centre de Pharmacologie Clinique (Inserm CIC1405), Clermont-Ferrand (CD, SS-S, CD, PS), Centre René-Huguenin, Anesthésie-Réanimation, Saint-Cloud (AA-F), Centre Jean-Perrin, Anesthésie-Réanimation, Clermont-Ferrand (BN), Centre Antoine-Lacassagne, Anesthésie-Réanimation, Nice (M-NF), CHU Clermont-Ferrand, Pôle Santé Publique (LO), and CHU Clermont-Ferrand, BLOC-ARCHI, Clermont-Ferrand, France (JB, PS).
authors.forename: Danièle
authors.initials: D
authors.lastname: Lefebvre-Kuntz
authors.forename: Christian
authors.initials: C
authors.lastname: Dualé
authors.forename: Aline
authors.initials: A
authors.lastname: Albi-Feldzer
authors.forename: Bertrand
authors.initials: B
authors.lastname: Nougarède
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Falewee
authors.forename: Lemlih
authors.initials: L
authors.lastname: Ouchchane
authors.forename: Sylvie
authors.initials: S
authors.lastname: Soule-Sonneville
authors.forename: Julie
authors.initials: J
authors.lastname: Bonneau
authors.forename: Claude
authors.initials: C
authors.lastname: Dubray
authors.forename: Pierre
authors.initials: P
authors.lastname: Schoeffler
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D018681:Anesthetics, General / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology / Q000209:etiology; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D018681:Anesthetics, General; D015742:Propofol