Submit Search
Upload
Neural blockade for persistent pain after breast cancer surgery
•
3 likes
•
235,368 views
Jason Attaman
Follow
Neural blockade for persistent pain after breast cancer surgery
Read less
Read more
Health & Medicine
Report
Share
Report
Share
1 of 7
Download now
Download to read offline
Recommended
Postmastectomy and Post Thoracotomy Pain
Postmastectomy and Post Thoracotomy Pain
Jason Attaman
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Jason Attaman
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
Jason Attaman
Pmr buzz-jan21
Pmr buzz-jan21
mrinal joshi
An Internet questionnaire to predict the presence or absence of organic patho...
An Internet questionnaire to predict the presence or absence of organic patho...
Nelson Hendler
Relief of urinary urgency, hesitancy, and male pelvic pain with pulsed radiof...
Relief of urinary urgency, hesitancy, and male pelvic pain with pulsed radiof...
Jason Attaman
Pulsed radiofrequency ablation of pudendal nerve for treatment of a case of r...
Pulsed radiofrequency ablation of pudendal nerve for treatment of a case of r...
Jason Attaman
E-book Dissertatie Coen Itz
E-book Dissertatie Coen Itz
Coen Itz
Recommended
Postmastectomy and Post Thoracotomy Pain
Postmastectomy and Post Thoracotomy Pain
Jason Attaman
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Jason Attaman
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
Jason Attaman
Pmr buzz-jan21
Pmr buzz-jan21
mrinal joshi
An Internet questionnaire to predict the presence or absence of organic patho...
An Internet questionnaire to predict the presence or absence of organic patho...
Nelson Hendler
Relief of urinary urgency, hesitancy, and male pelvic pain with pulsed radiof...
Relief of urinary urgency, hesitancy, and male pelvic pain with pulsed radiof...
Jason Attaman
Pulsed radiofrequency ablation of pudendal nerve for treatment of a case of r...
Pulsed radiofrequency ablation of pudendal nerve for treatment of a case of r...
Jason Attaman
E-book Dissertatie Coen Itz
E-book Dissertatie Coen Itz
Coen Itz
Tapering Long Term Opioid Therapy in Chronic Noncancer Pain
Tapering Long Term Opioid Therapy in Chronic Noncancer Pain
Ade Wijaya
Identification of neuropathic pain in patients with neck upper limb pain- app...
Identification of neuropathic pain in patients with neck upper limb pain- app...
Nathanael Amparo
Chronic Pain After Surgery
Chronic Pain After Surgery
Ade Wijaya
Apnea
Apnea
MedicinaIngles
NTG FINAL FINAL DRAFT
NTG FINAL FINAL DRAFT
Shea Dineen
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Jason Attaman
CIPNDrRusso
CIPNDrRusso
Dr Fred Russo
Pain, Heat, & Emotion. NEJM
Pain, Heat, & Emotion. NEJM
Paul Coelho, MD
Spinal cord stimulation in neuroparhic cancer pain
Spinal cord stimulation in neuroparhic cancer pain
Manish Raj
Fneur 12-601153
Fneur 12-601153
BHAYU RIZALLINOOR
Facet joint cervical
Facet joint cervical
felippeguariglia
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...
Nelson Hendler
Maladaptive movement and motor control impairments as underlying mechanism
Maladaptive movement and motor control impairments as underlying mechanism
Meziat
Medical shockwaves for chronic low back pain - a case series
Medical shockwaves for chronic low back pain - a case series
Kenneth Craig
Final Omt & Acup Stfm 27 April 2007
Final Omt & Acup Stfm 27 April 2007
MedicineAndHealthUSA
Rescue therapy headache
Rescue therapy headache
GaetanoTerranova2
Artigo - Acupuncture and physiotherapy for painful shoulder
Artigo - Acupuncture and physiotherapy for painful shoulder
Renato Almeida
MP Journal Of Anesthesiology Vol 1
MP Journal Of Anesthesiology Vol 1
isakakinada
Spinal Cord Stimulation Primer
Spinal Cord Stimulation Primer
yury
Studio sull'efficacia della deep brain stimulation in aggiunta alla terapia m...
Studio sull'efficacia della deep brain stimulation in aggiunta alla terapia m...
Merqurio
Pmr buzz magazine april 2021
Pmr buzz magazine april 2021
mrinal joshi
Effectiveness of manual physical therapy in cervical radiculopaty
Effectiveness of manual physical therapy in cervical radiculopaty
Delky Meza
More Related Content
What's hot
Tapering Long Term Opioid Therapy in Chronic Noncancer Pain
Tapering Long Term Opioid Therapy in Chronic Noncancer Pain
Ade Wijaya
Identification of neuropathic pain in patients with neck upper limb pain- app...
Identification of neuropathic pain in patients with neck upper limb pain- app...
Nathanael Amparo
Chronic Pain After Surgery
Chronic Pain After Surgery
Ade Wijaya
Apnea
Apnea
MedicinaIngles
NTG FINAL FINAL DRAFT
NTG FINAL FINAL DRAFT
Shea Dineen
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Jason Attaman
CIPNDrRusso
CIPNDrRusso
Dr Fred Russo
Pain, Heat, & Emotion. NEJM
Pain, Heat, & Emotion. NEJM
Paul Coelho, MD
Spinal cord stimulation in neuroparhic cancer pain
Spinal cord stimulation in neuroparhic cancer pain
Manish Raj
Fneur 12-601153
Fneur 12-601153
BHAYU RIZALLINOOR
Facet joint cervical
Facet joint cervical
felippeguariglia
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...
Nelson Hendler
Maladaptive movement and motor control impairments as underlying mechanism
Maladaptive movement and motor control impairments as underlying mechanism
Meziat
Medical shockwaves for chronic low back pain - a case series
Medical shockwaves for chronic low back pain - a case series
Kenneth Craig
Final Omt & Acup Stfm 27 April 2007
Final Omt & Acup Stfm 27 April 2007
MedicineAndHealthUSA
Rescue therapy headache
Rescue therapy headache
GaetanoTerranova2
Artigo - Acupuncture and physiotherapy for painful shoulder
Artigo - Acupuncture and physiotherapy for painful shoulder
Renato Almeida
MP Journal Of Anesthesiology Vol 1
MP Journal Of Anesthesiology Vol 1
isakakinada
Spinal Cord Stimulation Primer
Spinal Cord Stimulation Primer
yury
Studio sull'efficacia della deep brain stimulation in aggiunta alla terapia m...
Studio sull'efficacia della deep brain stimulation in aggiunta alla terapia m...
Merqurio
What's hot
(20)
Tapering Long Term Opioid Therapy in Chronic Noncancer Pain
Tapering Long Term Opioid Therapy in Chronic Noncancer Pain
Identification of neuropathic pain in patients with neck upper limb pain- app...
Identification of neuropathic pain in patients with neck upper limb pain- app...
Chronic Pain After Surgery
Chronic Pain After Surgery
Apnea
Apnea
NTG FINAL FINAL DRAFT
NTG FINAL FINAL DRAFT
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
CIPNDrRusso
CIPNDrRusso
Pain, Heat, & Emotion. NEJM
Pain, Heat, & Emotion. NEJM
Spinal cord stimulation in neuroparhic cancer pain
Spinal cord stimulation in neuroparhic cancer pain
Fneur 12-601153
Fneur 12-601153
Facet joint cervical
Facet joint cervical
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...
Maladaptive movement and motor control impairments as underlying mechanism
Maladaptive movement and motor control impairments as underlying mechanism
Medical shockwaves for chronic low back pain - a case series
Medical shockwaves for chronic low back pain - a case series
Final Omt & Acup Stfm 27 April 2007
Final Omt & Acup Stfm 27 April 2007
Rescue therapy headache
Rescue therapy headache
Artigo - Acupuncture and physiotherapy for painful shoulder
Artigo - Acupuncture and physiotherapy for painful shoulder
MP Journal Of Anesthesiology Vol 1
MP Journal Of Anesthesiology Vol 1
Spinal Cord Stimulation Primer
Spinal Cord Stimulation Primer
Studio sull'efficacia della deep brain stimulation in aggiunta alla terapia m...
Studio sull'efficacia della deep brain stimulation in aggiunta alla terapia m...
Similar to Neural blockade for persistent pain after breast cancer surgery
Pmr buzz magazine april 2021
Pmr buzz magazine april 2021
mrinal joshi
Effectiveness of manual physical therapy in cervical radiculopaty
Effectiveness of manual physical therapy in cervical radiculopaty
Delky Meza
Austin Journal of Musculoskeletal Disorders
Austin Journal of Musculoskeletal Disorders
Austin Publishing Group
Cefaleas
Cefaleas
Deysi Daniela Ordinola Calle
Outcome of Lumbar Fusion
Outcome of Lumbar Fusion
Paul Coelho, MD
Stemcell Research Paper on avascular necrosis-AVN-by Dr.Pradeep Mahajan
Stemcell Research Paper on avascular necrosis-AVN-by Dr.Pradeep Mahajan
Dr Pradeep Mahajan
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Jason Attaman
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...
Dr. Sherry N. Fanous MD, PHD, FIPP, DESA
Evaluating Chronic Pain Patients Using Methods from Johns Hopkins Hospital Ph...
Evaluating Chronic Pain Patients Using Methods from Johns Hopkins Hospital Ph...
Nelson Hendler
IJPR.2015.138
IJPR.2015.138
Sarfraznawaz Shah
Pain management in total knee replacement
Pain management in total knee replacement
Apollo Hospitals
Rischke_Viscoelastic Disc Arthroplasty Provides Superior Back and Leg Pain Re...
Rischke_Viscoelastic Disc Arthroplasty Provides Superior Back and Leg Pain Re...
Kari Zimmers
Dr. Sundeep Thesis Protocol PPT
Dr. Sundeep Thesis Protocol PPT
SANDEEP DAHIYA
The value of dynamic MRI in cervical spondylotic myelopathy: About 24 cases.T...
The value of dynamic MRI in cervical spondylotic myelopathy: About 24 cases.T...
Michel Triffaux
PMR Buzz Magazine_Oct 2022.pdf
PMR Buzz Magazine_Oct 2022.pdf
mrinal joshi
Pulsatile dry cupping in patients with
Pulsatile dry cupping in patients with
Lilin Rosyanti Poltekkes kemenkes kendari
Scrambler Therapy: An Innovative Neuromodulation Approach to Complex Regional...
Scrambler Therapy: An Innovative Neuromodulation Approach to Complex Regional...
Calmar Pain Relief Therapy, LLC
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
abhishak bhattacharjee
Running head NECK PAIN .docx
Running head NECK PAIN .docx
toltonkendal
Step by Step Stereotactic Planning of Meningioma: A Guide to Radiation Oncolo...
Step by Step Stereotactic Planning of Meningioma: A Guide to Radiation Oncolo...
Kanhu Charan
Similar to Neural blockade for persistent pain after breast cancer surgery
(20)
Pmr buzz magazine april 2021
Pmr buzz magazine april 2021
Effectiveness of manual physical therapy in cervical radiculopaty
Effectiveness of manual physical therapy in cervical radiculopaty
Austin Journal of Musculoskeletal Disorders
Austin Journal of Musculoskeletal Disorders
Cefaleas
Cefaleas
Outcome of Lumbar Fusion
Outcome of Lumbar Fusion
Stemcell Research Paper on avascular necrosis-AVN-by Dr.Pradeep Mahajan
Stemcell Research Paper on avascular necrosis-AVN-by Dr.Pradeep Mahajan
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Clinical effect and safety of pulsed radiofrequency treatment for pudendal ne...
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...
Knee Pain Management using Ultrasound- Guided Weberneedle Endo-laser in Compa...
Evaluating Chronic Pain Patients Using Methods from Johns Hopkins Hospital Ph...
Evaluating Chronic Pain Patients Using Methods from Johns Hopkins Hospital Ph...
IJPR.2015.138
IJPR.2015.138
Pain management in total knee replacement
Pain management in total knee replacement
Rischke_Viscoelastic Disc Arthroplasty Provides Superior Back and Leg Pain Re...
Rischke_Viscoelastic Disc Arthroplasty Provides Superior Back and Leg Pain Re...
Dr. Sundeep Thesis Protocol PPT
Dr. Sundeep Thesis Protocol PPT
The value of dynamic MRI in cervical spondylotic myelopathy: About 24 cases.T...
The value of dynamic MRI in cervical spondylotic myelopathy: About 24 cases.T...
PMR Buzz Magazine_Oct 2022.pdf
PMR Buzz Magazine_Oct 2022.pdf
Pulsatile dry cupping in patients with
Pulsatile dry cupping in patients with
Scrambler Therapy: An Innovative Neuromodulation Approach to Complex Regional...
Scrambler Therapy: An Innovative Neuromodulation Approach to Complex Regional...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Running head NECK PAIN .docx
Running head NECK PAIN .docx
Step by Step Stereotactic Planning of Meningioma: A Guide to Radiation Oncolo...
Step by Step Stereotactic Planning of Meningioma: A Guide to Radiation Oncolo...
More from Jason Attaman
CT-Guided Percutaneous Pulse-Dose Radiofrequency for Pudendal Neuralgia
CT-Guided Percutaneous Pulse-Dose Radiofrequency for Pudendal Neuralgia
Jason Attaman
Pulsed Radiofrequency of Pudendal Nerve for Treatment in Patients with Pudend...
Pulsed Radiofrequency of Pudendal Nerve for Treatment in Patients with Pudend...
Jason Attaman
Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disor...
Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disor...
Jason Attaman
IWIALLXUU28
IWIALLXUU28
Jason Attaman
VUVD86FYNi4F
VUVD86FYNi4F
Jason Attaman
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Jason Attaman
Ultrasound-guided pudendal nerve pulsed radiofrequency in patients with refra...
Ultrasound-guided pudendal nerve pulsed radiofrequency in patients with refra...
Jason Attaman
Ultrasound guided pudendal nerve pulsed radiofrequency in patients with refra...
Ultrasound guided pudendal nerve pulsed radiofrequency in patients with refra...
Jason Attaman
Prp intradiskal 2015
Prp intradiskal 2015
Jason Attaman
Pettine et al treatment of discogenic back pain with autologous bmc inje...
Pettine et al treatment of discogenic back pain with autologous bmc inje...
Jason Attaman
Percutaneous injection of autologous bm concentrate cells significantly reduc...
Percutaneous injection of autologous bm concentrate cells significantly reduc...
Jason Attaman
Qutenza Patient Guide
Qutenza Patient Guide
Jason Attaman
Jason G. Attaman, DO, FAAPMR Presents: Image Guided Platelet Rich Plasma (PRP...
Jason G. Attaman, DO, FAAPMR Presents: Image Guided Platelet Rich Plasma (PRP...
Jason Attaman
Dr. Attaman New Patient Intake Form
Dr. Attaman New Patient Intake Form
Jason Attaman
The Pain-Sleep Nexus
The Pain-Sleep Nexus
Jason Attaman
More from Jason Attaman
(15)
CT-Guided Percutaneous Pulse-Dose Radiofrequency for Pudendal Neuralgia
CT-Guided Percutaneous Pulse-Dose Radiofrequency for Pudendal Neuralgia
Pulsed Radiofrequency of Pudendal Nerve for Treatment in Patients with Pudend...
Pulsed Radiofrequency of Pudendal Nerve for Treatment in Patients with Pudend...
Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disor...
Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disor...
IWIALLXUU28
IWIALLXUU28
VUVD86FYNi4F
VUVD86FYNi4F
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Ultrasound guided pulsed radiofrequency treatment of the pudendal nerve in ch...
Ultrasound-guided pudendal nerve pulsed radiofrequency in patients with refra...
Ultrasound-guided pudendal nerve pulsed radiofrequency in patients with refra...
Ultrasound guided pudendal nerve pulsed radiofrequency in patients with refra...
Ultrasound guided pudendal nerve pulsed radiofrequency in patients with refra...
Prp intradiskal 2015
Prp intradiskal 2015
Pettine et al treatment of discogenic back pain with autologous bmc inje...
Pettine et al treatment of discogenic back pain with autologous bmc inje...
Percutaneous injection of autologous bm concentrate cells significantly reduc...
Percutaneous injection of autologous bm concentrate cells significantly reduc...
Qutenza Patient Guide
Qutenza Patient Guide
Jason G. Attaman, DO, FAAPMR Presents: Image Guided Platelet Rich Plasma (PRP...
Jason G. Attaman, DO, FAAPMR Presents: Image Guided Platelet Rich Plasma (PRP...
Dr. Attaman New Patient Intake Form
Dr. Attaman New Patient Intake Form
The Pain-Sleep Nexus
The Pain-Sleep Nexus
Recently uploaded
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
aliya bhat
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
parulsinha
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
narwatsonia7
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
narwatsonia7
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
narwatsonia7
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
9953056974 Low Rate Call Girls In Saket, Delhi NCR
Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024
Gabriel Guevara MD
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Nehru place Escorts
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
narwatsonia7
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
narwatsonia7
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
Miss joya
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
parulsinha
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
sonalikaur4
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
narwatsonia7
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Call Girls In Delhi Whatsup 9873940964 Enjoy Unlimited Pleasure
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Nehru place Escorts
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
nehamumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
sonalikaur4
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
narwatsonia7
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
9953056974 Low Rate Call Girls In Saket, Delhi NCR
Recently uploaded
(20)
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
Neural blockade for persistent pain after breast cancer surgery
1.
Neural Blockade for
Persistent Pain After Breast Cancer Surgery Nelun Wijayasinghe, MBBS, BSc, FRCA, Kenneth G. Andersen, MD, and Henrik Kehlet, MD, PhD Abstract: Persistent pain after breast cancer surgery is predominantly a neuropathic pain syndrome affecting 25% to 60% of patients and related to injury of the intercostobrachial nerve, intercostal nerves, and other nerves in the region. Neural blockade can be useful for the identification of nerves involved in neuropathic pain syndromes or to be used as a treatment in its own right. The purpose of this review was to examine the evidence for neural blockade as a potential diagnostic tool or treat- ment for persistent pain after breast cancer surgery. In this systematic review, we found only 7 studies (n = 135) assessing blocks directed at 3 neural structures—stellate ganglion, paravertebral plexus, and inter- costal nerves—but none focusing on the intercostobrachial nerve. The quality of the studies was low and efficacy inconclusive, suggesting a need for well-designed, high-quality studies for this common clinical problem. (Reg Anesth Pain Med 2014;39: 272–278) Persistent pain after breast cancer surgery (PPBCS) affects 25% to 60% of patients treated for breast cancer,1,2 even several years after surgery.3 Patients develop a syndrome of pain in the axilla, medial side of the upper arm, and breast or lateral chest wall that is predominantly neuropathic in nature.4 Persis- tent pain is defined as pain lasting more than 3 months after surgery.1 It can develop after all forms of breast cancer surgery such as mastectomy with or without axillary lymph node dissec- tion and sentinel lymph node biopsy. Neuropathic pain has been defined as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system” and its grading system explains the heterogeneity of neu- ropathic pain syndromes which can be applied to PPBCS.5 The authors of this definition also stress the importance of discriminat- ing between a central and peripheral neuropathic pain. Identi- fication of this “lesion” may be key in determining strategies for diagnosis and treatment of PPBCS. The innervation of the breast arises from the intercostal nerves T2 to T6, and during surgery, the intercostobrachial nerve (ICBN) (T2) and medial cutaneous nerve of the arm (C8-T1) are also vulnerable to damage (Fig. 1). Other nerves that may be affected during surgery are the long thoracic, thoracodorsal, lateral, and medial pectoral, but these lead mainly to functional deficits. Patients treated with axillary lymph node dissection often report more persistent pain than patients treated with sen- tinel lymph node biopsy,1 raising suspicions of damage of the ICBN as an important part of the pain pathophysiology in PPBCS and confirmed by the distribution of pain and sensory abnormalities.6,7 However, surgical strategies to preserve the ICBN and prevent the development of PPBCS have been equivocal.8–10 The mainstay treatment for PPBCS is predominantly phar- macological. However, neural blockade is a widely used proce- dure for chronic pain conditions and can be useful for diagnosis and treatment for neuropathic pain conditions.11,12 Thus, the pur- pose of this review is to examine the available evidence for neural blockade for PPBCS. METHODS We wrote our protocol per instructions in the Cochrane handbook13 for systematic reviews of interventional studies and using PRISMA14 guidelines. In October 2013 and March 2014, we conducted literature searches using the following databases: MEDLINE via PubMed (1809-current date), Scopus (1823-current date), and EMBASE (1980-current date). We used the following MeSH terms: [breast neoplasms/surgery AND neural blockade] [breast neoplasms/surgery AND intercostobrachial] [breast cancer (MAJR topic) AND surgery (MAJR topic) AND pain (MAJR topic)] [breast cancer pain AND intercostobrachial nerve] and the following keywords in all three databases: [intercostobrachial], [(intercostobrachial AND breast cancer)], [(intercostobrachial) AND (breast cancer pain)], [(intercostobrachial) AND (blockade) AND (breast)], [(medial cutaneous nerve) AND (breast pain)], [(pectoral nerves) AND (breast pain)], [(long thoracic nerve) AND (breast pain)], [(thoracodorsal nerve) AND (breast pain)], [(intercostal nerves) AND (breast pain)] [(medial cutaneous nerve block) AND (breast cancer )], [(pectoral nerve block) AND (breast cancer)], [(long thoracic nerve block) AND (breast cancer)], [(thoracodorsal nerve block) AND (breast cancer)], [(intercostal nerve block) AND (breast cancer)].The reference lists from relevant papers were also searched. Inclusion Criteria We only included studies written in English concerning patients who had undergone breast cancer surgery, had developed persistent pain, and received a local anesthetic block in the course of their treatment for their pain. Exclusion Criteria We excluded studies on phantom breast pain, the use of neu- ral blockade in the perioperative period, and treatments for PPBCS that did not target nerves (Fig. 2). The studies were graded using the Grades of Recommendation, Assessment, Development and Evaluation15 approach to determine the quality of the evidence. The Grades of Recommendation, Assessment, Development and Evaluation approach classifies studies into the following From the Section for Surgical Pathophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Accepted for publication April 14, 2014. Address correspondence to: Nelun Wijayasinghe, MBBS, BSc, FRCA, Section for Surgical Pathophysiology 4074, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark (e‐mail: nelun.wijayasinghe@regionh.dk). The authors declare no conflict of interest. This study was funded by a grant from the Danish Cancer Society and the study is part of the European Collaboration, which has received support from the Innovative Medicines Initiative Joint Undertaking, under grant agreement no. 115007, resources which are composed of financial contributions from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies in kind contribution. Copyright © 2014 by American Society of Regional Anesthesia and Pain Medicine ISSN: 1098-7339 DOI: 10.1097/AAP.0000000000000101 REVIEW ARTICLE 272 Regional Anesthesia and Pain Medicine • Volume 39, Number 4, July-August 2014 Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
2.
categories: high, moderate,
low, or very low, depending on the type of evidence. RESULTS Study Selection and Characteristics The literature search yielded a total of 752 articles, of which only 8 were eligible (Fig. 1). The large number of duplicates was due to the large overlap between PubMed and Scopus databases. There were no studies involving the medial cutaneous, lateral pec- toral, medial pectoral, thoracodorsal, or long thoracic nerves. One study using paravertebral plexus stimulation16 was excluded as it did not include any form of local anesthetic blockade (Fig. 1). Thus, our searches identified 7 studies for analysis, namely, 4 studies17–20 that used diagnostic nerve blocks and 3 therapeutic nerve block studies.21,22 Two of the analyzed studies also included thoracotomy patients18,23 or abdominal surgical patients,18 but only the breast surgery patients from these studies were analyzed. All of the diagnostic nerve blocks involved the intercostal nerves and the therapeutic nerve blocks involved 2 stellate ganglion block (SGB) studies and 1 paravertebral block (PVB) study (Table 1). Intercostal Nerve Block Studies All of the 4 intercostal nerve block studies were performed in case series (n = 15) and 8 (53%) of 15 patients had complete pain relief from the local anesthetic blockade.17–20 All 4 studies used the block to aid the course of further treatment that consisted of 3 surgical treatments17,18,20 and 1 neurolytic treatment.19 The in- sufficient design, heterogeneity of pain evaluation, and lack of control groups in these studies made statistical analysis and con- clusions impossible (Table 1). SGB Studies The 2 SGB studies21,22 showed statistically significant re- ductions in pain scores for up to 3 months after the blocks, but 8 (11%) of 75 patients were nonresponders to the block (Table 1). However, gabapentin provided better pain relief (reduction in numerical rating scale) than SGB in 1 study.21 The low quality of the studies, with lack of appropriate control group and blinding of investigators impedes sufficient interpretation. PVB Study In the PVB study,23 2 (20%) of 10 patients were pain-free after 5 months. Interpretation of this study is hindered by incon- sistent number of blocks in each patient, lack of control, and in- sufficient blinding of investigators (Table 1). DISCUSSION This review demonstrates a lack of high-quality research into neural blockade in PPBCS which is predominantly a “neuropathic FIGURE 1. Innervation of the breast and location of the nerves at risk during breast cancer surgery. ICBN indicates intercostobrachial nerve (sensory only); II-VI, intercostal nerves 2 to 6, lateral cutaneous branches (sensory only); LPN, lateral pectoral nerve (mixed sensory and motor); LTN, long thoracic nerve (motor only); MCN, medial cutaneous nerve of the arm (sensory only); MPN, medial pectoral nerve (mixed sensory and motor); TDN, thoracodorsal nerve (motor only). Regional Anesthesia and Pain Medicine • Volume 39, Number 4, July-August 2014 Nerve Blocks for PPBCS © 2014 American Society of Regional Anesthesia and Pain Medicine 273 Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
3.
pain syndrome.”1,4 Thus, most
(4 of 7) studies were small case series of 5 patients or less,17–20 1 retrospective study (10 patients)23 and only 2 randomized but not placebo-controlled trials (110 patients).21,22 None of the studies was investigator-blinded. Three studies had unclear pain assessments.17,18,23 The use of grading scales places this evidence as low to very low quality.15 No study specifically addressed the potential for blockade of the ICBN, despite the high probability of this nerve’s involvement in the development of PPBCS.1,8,9 Finally, there was a surprising lack of studies of diagnostic and/or therapeutic local anesthetic peripheral nerve blocks, in contrast to the common use in other pain conditions24 and in relation to the general acceptance of the clinical importance of PPBCS. Local anesthetic injection could potentially be used as a diag- nostic tool, as seen in 4 of the studies in our review, for assessing the suitability of different treatments.17–20 Thus, positive response to local anesthetic injection of the intercostal nerves was a neces- sary criterion for the diagnosis of neuroma17,20 and nerve entrap- ment18 as well as identification of the paravertebral nerves for radiofrequency ablation,19 and interestingly, each study had a dif- ferent level of response to the local anesthetic. These 4 case series17–20 represent the only data that we could find in the litera- ture of diagnostic blocks in PPBCS, thereby challenging the value of a diagnostic neural blockade in the characterization of PPBCS as well as suitability for neurectomy or neurolysis. The use of the SGB for the treatment of neuropathic pain conditions of the arm is not a new concept25 but for PPBCS we found only 2 studies with this block.21,22 However, the rationale for the use of SGB is unclear with respect to the anatomy of PPBCS as these studies state that 80% to 100% of patients with PPBCS had damage to the ICBN,21,22 which originates from the second intercostal nerve. But, the stellate ganglion encompasses lower cervical roots and the first thoracic root, hence questioning the rationale for SGB. Interestingly, gabapentin gave a better anal- gesic response when compared to SGB.21 Surprisingly, there was only 1 therapeutic study of PVBs for PPBCS,23 whereas the rationale for these blocks is sound and the risk profile is similar to SGBs. A high proportion of blocks (88%) provided good initial pain relief, but unfortunately this was a ret- rospective study with insufficient study design.23 Nevertheless, the positive data from trials with “preventive” PVBs on develop- ment of PPBCS after breast surgery26 emphasize the need for fur- ther studies with a randomized, placebo-controlled design. Although chronic pain practitioners may use peripheral nerve blockade in their practice as part of their treatment re- gimens, we could not find any studies supporting this practice in PPBCS or high-quality studies in other types of persistent postop- erative pain.24,27 Vlassakov et al24 found 12 studies of different peripheral nerve blockades in chronic pain conditions and all showed convincing results in terms of greater than 50% pain relief and pain relief that outlasted the conduction block of the local an- esthetic. Again, these were small case series and none of these studies were placebo-controlled, thereby limiting any firm con- clusions as to the usefulness of these treatments. The importance of using placebo can be seen in a well-designed randomized, placebo-controlled, double-blinded crossover trial examining the effects of peripheral nerve blockade in postherniotomy pain patients.28 The results showed the same pain response after pla- cebo compared with after local anesthetic blockade and also found a high proportion (5 of 12) of patients were placebo responders, casting doubt on much of the previous research on peripheral nerve blockade. It is generally assumed that ICBN injury may contribute to PPBCS, especially in axillary dissection.1,8,9 It is therefore sur- prising that no specific ICBN blockade study is available in the lit- erature. No studies assessing the role of the medial cutaneous nerve in PPBCS were found despite its vulnerable location in the axilla. The same is true for the other nerves that are poten- tially at risk; we did not find any studies looking at the thora- codorsal, medial pectoral, lateral pectoral, or long thoracic nerves FIGURE 2. Flow of information for nerve blockade for PPBCS. Wijayasinghe et al Regional Anesthesia and Pain Medicine • Volume 39, Number 4, July-August 2014 274 © 2014 American Society of Regional Anesthesia and Pain Medicine Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
4.
TABLE1.NerveBlockStudiesinPPBCS BlockStudyAuthorandYearStudyDescriptionLAUsedOutcomeandPurposeofBlockadeComments DiagnosticblocksIntercostal nerveblock Wong17 2001Caseseries:5postmastectomy patientsundergoing neuromaresection Lidocaine1%at siteofTinelsign Allptshadcompletepainrelief. Thisprovidedconfirmation asacandidateforsurgery Weaknesses 1patientdevelopedpaininthe regionoftheICBNafter surgerybutptswithICBN involvementweresupposed tobeexcluded Painevaluationnotdescribed Nopainscorespresented Smallnumberofpatients Nocontrolgroup Noblindingofinvestigators Qualityofevidence:verylow DucicandLarson18 2006Caseseries:4patientsafter breastsurgeryundergoing surgicalreleaseofnerves undertension;3patientshad previoussurgeryforbreast cancerand1mastopexy Lidocaine1%“around” branchofintercostal nerve Allpatientshadatleast 50%reliefofsymptoms. Thisresponsewasused toidentifythenerves forsurgery Weaknesses Thespecificsymptoms alleviatedbyLAnotdescribed Painscoresnotpresented Heterogeneousgroupofpatients Smallno.patients Noblindingofinvestigators Nocontrolgroup Qualityofevidence:verylow Uchida19 2009Caseseries:3postmastectomy patientsundergoing radiofrequencyablation tothoracicparavertebral nervesmultiplelevels LAnotstated.Intercostal nerveblock Allpatientshadatemporary response:>80%painrelief withLA.Thisresponsewas usedtoidentifythelevelsfor radiofrequencyablation Strengths Painassessmentdescribed Neuropathiccomponentsof painassessed Weaknesses Glucocorticoidsaddedto LAinjection Temporaryresponsenotdefined Smallno.patients Noblindingofinvestigators Nocontrolgroup Qualityofevidence:verylow (Continuednextpage) Regional Anesthesia and
Pain Medicine • Volume 39, Number 4, July-August 2014 Nerve Blocks for PPBCS © 2014 American Society of Regional Anesthesia and Pain Medicine 275 Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
5.
TABLE1.(Continued) BlockStudyAuthorandYearStudyDescriptionLAUsedOutcomeandPurposeofBlockadeComments Nguyenetal20 2012 Caseseries:3postbreast surgerypatients undergoingneuroma resectionsurgery. Pt1haddouble mastectomy+implants but1-sidedbreast pain.Pt2hadbreast augmentationand bilateralneuromas. Pt3hadbreast augmentationand single-sidedneuroma Pt1:Lidocaine 1%injected intotender point.Pt2and3: LAinjectedinto tenderpoints. LAnotstated Allpatientshadcomplete painrelief.Thisresponse confirmedthediagnosis ofaneuroma Pt3developedbilateralsubareolar painandtheimplantswere removed Strengths Painscores Paindescription Weaknesses LAnotstatedin2of3patients Heterogeneousgroupofpatients Smallno.patients Noblindingofinvestigators Nocontrolgroup Qualityofevidence:verylow TherapeuticblocksSGBHoseinzadeetal21 2008 Randomizedtrialof 60patients.All patientshadbreast cancersurgery. ComparisonofSGB withgabapentinSGB every5d(max 5blocksperpt) 8mL0.25%bupivacaineNRSreducedfrom 7.46(1.07)to1.73(1.59) butgreaterreductionin NRSwithgabapentin: 7.40(0.85)to0.53(0.50) after3mo;5ptswere nonresponders(ie,had nopainrelieffromthe block);5ptshad “incompletepainrelief” (seeweaknesses) Strengths Randomizedstudy Painscores Neuropathiccomponents ofpainassessed Strictinclusioncriteria Weaknesses Inconsistentno.blocksperpt Noplacebocontrolgroup Noblindingofinvestigators Definitionofincomplete painreliefwasnot described Qualityofevidence:low NabilAbbasetal22 2011 Randomizedtrialof 50postmastectomy patients.Comparison of2differentapproaches ofthesameblock.Total of191SGBs:4oneach patientat1-wkintervals; 25ptsclassicapproach; 25ptsobliqueapproach 5mL0.25%bupivacaine3ptswerenonresponders (ie,hadnopainrelief afterthefirstblock) andwerewithdrawn fromthestudy.47pts had>50%reductionin painonVASafter3mo Thisstudyexaminedthe differencebetweenthe 2techniquesofSGBand nottheblock’sefficacy Strengths Randomizedstudy Painscores Allodyniaassessed Ptsatisfactionscores Weaknesses Noplacebocontrolgroup Noblindingofinvestigators Wijayasinghe et al
Regional Anesthesia and Pain Medicine • Volume 39, Number 4, July-August 2014 276 © 2014 American Society of Regional Anesthesia and Pain Medicine Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
6.
in PPBCS. The
intercostal nerves contribute to pain in the breast29 as opposed to pain in the axilla and arm that is more commonly seen in PPBCS. Therefore, thorough assessment of patients is cru- cial to identify the potential nerves involved to administer the ap- propriate block. The main limitation of this review is that the studies analyzed were of low quality due to unsystematic study design despite the common problem of PPBCS. Although the studies included in this review demonstrated a high proportion of positive results, this could be due to publication bias where positive findings are published more often than negative ones.30 Further research on the usefulness of diagnostic or therapeutic neural blockade of PPBCS should be conducted in double-blind, randomized, con- trolled studies. Because several risk factors for the develop- ment of PPBCS have been identified1,9,31 and should be controlled for, the variation in patient characteristics will render studies with small numbers difficult to interpret. Finally, pain charac- terization should be done using recommendations according to the IMMPACT criteria32 and including procedure-specific mea- surements of pain-related functional impairment. In conclusion, this systematic review highlights the sparse clinical data of nerve blockade in PPBCS despite being predomi- nantly a “neuropathic pain” condition. Although injury to the ICBN is an important pathogenic factor in PPBCS, no studies are available aiming at blocking this nerve. Because PPBCS is clinically important, well-designed, placebo-controlled nerve block studies are warranted. REFERENCES 1. Andersen KG, Kehlet H. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain. 2011; 12:725–746. 2. Belfer I, Schreiber KL, Shaffer JR, et al. Persistent postmastectomy pain in breast cancer survivors: analysis of clinical, demographic, and psychosocial factors. J Pain. 2013;14:1185–1195. 3. Mejdahl MK, Andersen KG, Gartner R, Kroman N, Kehlet H. Persistent pain and sensory disturbances after treatment for breast cancer: six year nationwide follow-up study. BMJ. 2013;346:f1865. 4. Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH. Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain. 2003;104:1–13. 5. Treede RD, Jensen TS, Campbell JN, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–1635. 6. Vecht CJ, Van de Band HJ, Wajer OJ. Post-axillary dissection pain in breast cancer due to a lesion of the intercostobrachial nerve. Pain. 1989;38: 171–176. 7. Paredes JP, Puente JL, Potel J. Variations in sensitivity after sectioning the intercostobrachial nerve. Am J Surg. 1990;160:525–528. 8. Taira N, Shimozuma K, Ohsumi S, et al. Impact of preservation of the intercostobrachial nerve during axillary dissection on sensory change and health-related quality of life 2 years after breast cancer surgery. Breast Cancer. 2014;21:183–190. 9. Bruce J, Thornton AJ, Powell R, et al. Psychological, surgical, and sociodemographic predictors of pain outcomes after breast cancer surgery: a population-based cohort study. Pain. 2014;155:232–243. 10. Salmon RJ, Ansquer Y, Asselain B. Preservation versus section of intercostal-brachial nerve (IBN) in axillary dissection for breast cancer—a prospective randomized trial. Eur J Surg Oncol. 1998;24:158–161. 11. Abram SE. Neural blockade for neuropathic pain. Clin J Pain. 2000;16: S56–S61. ThoracicPVBKirvelaand Antila23 1992 Retrospectivecaseseries duringa4-yearperiod: 10postmastectomy patientswhoreceived 112PVBs 20mL0.5%bupivacaine2of10patientswerepain-free >5mo.88%ofblocks provided≥75%painrelief for<1mo.6%ofblocks provided≥75%painrelief for>5mo Weaknesses Retrospectivestudy Unclearassessmentofpain:all patientswerereferredwith unverified“neuralgia” Inconsistentno.blocksperpt Noinformationofhowmany blockseachpatientgot Noinformationoftheperiod betweenblocks Calculationofthepainrelief outcomesnotdescribed Resultsarereportedas percentageofblocks Nocontrolgroup Noblindingofinvestigators Qualityofevidence:verylow LAindicateslocalanesthetic;NRS,numericalratingscale;pt,patient;QOL,qualityoflife;VAS,visualanalogscale. Regional Anesthesia and Pain Medicine • Volume 39, Number 4, July-August 2014 Nerve Blocks for PPBCS © 2014 American Society of Regional Anesthesia and Pain Medicine 277 Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
7.
12. Arner S,
Lindblom U, Meyerson BA, Molander C. Prolonged relief of neuralgia after regional anesthetic blocks. A call for further experimental and systematic clinical studies. Pain. 1990;43:287–297. 13. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available at http://handbook.cochrane.org/. 14. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339:b2700. 15. Brozek JL, Akl EA, Alonso-Coello P, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64:669–677. 16. Hegarty D, Goroszeniuk T. Peripheral nerve stimulation of the thoracic paravertebral plexus for chronic neuropathic pain. Pain Physician. 2011;14:295–300. 17. Wong L. Intercostal neuromas: a treatable cause of postoperative breast surgery pain. Ann Plast Surg. 2001;46:481–484. 18. Ducic I, Larson EE. Outcomes of surgical treatment for chronic postoperative breast and abdominal pain attributed to the intercostal nerve. J Am Coll Surg. 2006;203:304–310. 19. Uchida K. Radiofrequency treatment of the thoracic paravertebral nerve combined with glucocorticoid for refractory neuropathic pain following breast cancer surgery. Pain Physician. 2009;12:E277–E283. 20. Nguyen JT, Buchanan IA, Patel PP, Aljinovic N, Lee BT. Intercostal neuroma as a source of pain after aesthetic and reconstructive breast implant surgery. J Plast Reconstr Aesthet Surg. 2012;65:1199–1203. 21. Hoseinzade H, Mahmoodpoor A, Agamohammadi D, Sanaie S. Comparing the effect of stellate ganglion block and gabapentin on the post mastectomy pain syndrome. RMJ. 2008;33:22–25. 22. Nabil Abbas D, Abd El Ghafar EM, Ibrahim WA, Omran AF. Fluoroscopic stellate ganglion block for postmastectomy pain: a comparison of the classic anterior approach and the oblique approach. Clin J Pain. 2011; 27:207–213. 23. Kirvela O, Antila H. Thoracic paravertebral block in chronic postoperative pain. Reg Anesth. 1992;17:348–350. 24. Vlassakov KV, Narang S, Kissin I. Local anesthetic blockade of peripheral nerves for treatment of neuralgias: systematic analysis. Anesth Analg. 2011;112:1487–1493. 25. Bonica JJ. Sympathetic Nerve Blocks for Pain Diagnosis and Therapy. New York, NY: Winthrop-Breon Laboratories, 1984. 26. Andreae MH, Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013;111:711–720. 27. Carr DB. Local anesthetic blockade for neuralgias: “why is the sky blue, daddy?” Anesth Analg. 2011;112:1283–1285. 28. Bischoff JM, Koscielniak-Nielsen ZJ, Kehlet H, Werner MU. Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks for persistent inguinal postherniorrhaphy pain: a randomized, double-blind, placebo-controlled, crossover trial. Anesth Analg. 2012;114: 1323–1329. 29. Ducic I, Seiboth LA, Iorio ML. Chronic postoperative breast pain: danger zones for nerve injuries. Plast Reconstr Surg. 2011;127:41–46. 30. Dickersin K. The existence of publication bias and risk factors for its occurrence. JAMA. 1990;263:1385–1389. 31. Miaskowski C, Cooper B, Paul SM, et al. Identification of patient subgroups and risk factors for persistent breast pain following breast cancer surgery. J Pain. 2012;13:1172–1187. 32. Dworkin RH, Turk DC, Farrar JT, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain. 2005;113:9–19. Wijayasinghe et al Regional Anesthesia and Pain Medicine • Volume 39, Number 4, July-August 2014 278 © 2014 American Society of Regional Anesthesia and Pain Medicine Copyright © 2014 American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.
Download now