Pain management after major oncological breast surgery: an updated systematic review and procedure specific postoperative pain management ( PROSPECT ) recommendations
Methodological detailsPROSPECT, modified Delphi process
- PROSPECT
- Modified Delphi process
Recommendations
As issued by the authors
Paracetamol, NSAIDs or cyclooxygenase-2 inhibitors, and dexamethasone continue to be advocated
Gabapentin no longer recommended (problematic adverse effects)
Single-shot ESP block; interpectoral and pectoserratus plane block; superficial serratus anterior plane block; deep serratus anterior plane block; thoracic paravertebral block; and local infiltration analgesia recommended
Continuous thoracic paravertebral block no longer recommended; single-shot regional modalities suffice for the worst part of acute pain
Pre- and postoperative physiotherapy recommended
No perineural adjuncts, specific surgical techniques or complementary medicine therapies recommended
Listed single-shot regional analgesic techniques considered equivalent to each other
Original publication
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