Effect of integrating Yoga along with multimodal pain management approach on post-mastectomy pain syndrome in patients undergoing breast cancer surgery.

Abstract

Abstract Aim & Background: To evaluate the efficacy of Yogic intervention (pranayama) along with integrated multimodal approach on the incidence and severity of post mastectomy pain syndrome (PMPS) in patients undergoing surgery for breast cancer. Materials and methods: Forty patients aged 20-65 years undergoing breast cancer surgery of American Society of Anaesthesiologists physical status I – II were included. All patients received thoracic paravertebral block and tablet pregabalin till the end of the fourth postoperative week. Patients were randomly allocated into one of the two groups; “Control” and “Yoga.” Patients in the Yoga group practiced yogic exercise “Anulom-vilom’’ from post operative day 3 till day 90. The primary outcome was incidence of PMPS and secondary outcomes include Pain Detect Questionnaire (PDQ) score, Neuropathic Pain Symptom Inventory (NPSI) score, Activity assessment scores (AAS) and Quality of Life (QoL) using Short Form (SF)-12 score. Results: A reduced incidence of PMPS (10% vs 30%), mean VAS pain score, PDQ, and NPSI was observed in Yoga group along with improvement in SF-12 scores and AAS score in post mastectomy patients; however, not statistically significant. Conclusion: This study encourages the integration of yoga along with multimodal pain management approach for PMPS.