• Kazuma Hashimoto, Ayano Tsuji, Shiho Takenaka, Akimune Ohmura, Ryusuke Ueki, Hideki Noma, Michiko Imamura, Yasuo Miyoshi, Nobutaka Kariya, Tsuneo Tatara, and Munetaka Hirose.
• Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Hyogo, Japan.
• Anesth Pain Med. 2018 Aug 1; 8 (4): e79331.

BackgroundC-reactive protein (CRP) is an acute phase reactant released in response to inflammation or tissue injury. Inflammation is one of the pathogenic factors related to transition from acute postsurgical pain (APSP) to chronic postsurgical pain (CPSP). Although several risk factors are reportedly associated with CPSP, the effects of CRP levels on CPSP have not been examined.ObjectivesThe present study investigated the relationship between perioperative risk factors, including CRP levels on postoperative day one and CPSP, in patients undergoing mastectomy.MethodsPreoperative anxiety and depression levels were evaluated in female patients undergoing mastectomy under general anesthesia, with or without peripheral nerve block. Patients with chronic preoperative pain and/or preoperative breast pain were excluded. The intensity of postoperative pain was prospectively examined one and six days, and three and twelve months after surgery using a numerical rating scale (NRS).ResultsThe current researchers conducted univariate and multivariate linear regression analyses to explore risk factors for CPSP in 36 patients. Patient demographics, preoperative psychological states, and anesthetic managements showed no relationship with CPSP. On the other hand, pain intensity of APSP and CRP levels on postoperative day one was significantly associated with the pain intensity of CPSP.ConclusionsPostoperative CRP level is likely to be associated with the development of CPSP after mastectomy.

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