The Role of Muscle Relaxants – Spasmolytic (Thiocochlicoside) in Postoperative Pain Management after Mastectomy and Breast Reconstruction

Document Type: Research Articles

Authors

1 Department of Anesthesiology, Hellenic Anticancer Institute, Saint Savvas Hospital, Greece.

2 Department of Medical Laboratories, University of West Attikis, Greece.

3 Department of Plastic Surgery, Saint Savvas Hospital, Greece.

4 Department of Nursing, University of West Attikis, Greece.

5 Department of Nursing, Technological Educational Institute of Athens, Athens, Greece.

Abstract

Purpose: Post-operative pain after breast cancer surgery is a major problem and women undergoing mastectomy
and breast reconstruction experience post-operative pain syndromes in approximately one-half of all cases. Patients
who have undergone breast reconstruction after mastectomy can suffer from acute postoperative pain with moderate
or strong tension. In some cases, chronic neuropathic pain syndromes may occur after surgery. Opioids are used to
treat pain, with serious side effects. The systemic postoperative analgesic regimen as thiocochlicoside P.O. along
with paracetamol and NSAIDs I.V., which may limit the administration of opioids without reducing pain relief,
seems to be necessary. Materials and Methods: This study was a clinical trial randomizing 70 patients undergoing
breast reconstruction. Two main protocols of systematic post-operative analgesia, one using thiocochlicoside (group
A) and the other without them (group B), were used. Both groups received paracetamol X3 and lornoxicam X2 I.V.
systematically. The pain measurement scale (NPS) used to measure post-operative pain. Likert scales were used to
evaluate patient’s satisfaction and the difficulty from the side effects . An anonymous questionnaire was used for the
data collection. Results: Statistically significant difference was found between pain on the day of surgery (p = 0.017)
as well as the three subsequent days (p = 0.000). In group A , pain was reduced directly to half (Χ2 surgery pain =
93.888, p = 0.000) especially on the first post-operative day. In group A the satisfaction with analgesic treatment was
higher than in group B (p = 0.002). Conclusion: The use of thiocochlicoside in post-operative analgesia in breast
reconstruction after mastectomy contributes to reduce the pain intensity experienced by patients and to reduce the side
effects of opioid analgesics as a result of reduced demand for opioid analgesics. Patients who received the analgesia
using muscle relaxants-spasmolytic reported greater satisfaction.

Keywords

Main Subjects